Provider Demographics
NPI:1356300164
Name:ECKHART, SHARON B (ARNP, CS)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:B
Last Name:ECKHART
Suffix:
Gender:F
Credentials:ARNP, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301
Mailing Address - Country:US
Mailing Address - Phone:712-580-3882
Mailing Address - Fax:712-580-3932
Practice Address - Street 1:2016 HWY BLVD SOUTH
Practice Address - Street 2:SUITE
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301
Practice Address - Country:US
Practice Address - Phone:712-262-1808
Practice Address - Fax:712-262-5532
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAT-067669363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0449835Medicaid
IAI8771Medicare PIN
S96820Medicare UPIN
IA0449835Medicaid