Provider Demographics
NPI:1396921979
Name:NAYLOR, SHARON M (FNP-BC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:NAYLOR
Suffix:
Gender:F
Credentials:FNP-BC
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 336
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KY
Mailing Address - Zip Code:40440-0336
Mailing Address - Country:US
Mailing Address - Phone:270-943-8202
Mailing Address - Fax:
Practice Address - Street 1:3115 KY HIGHWAY 698
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:KY
Practice Address - Zip Code:40484-9441
Practice Address - Country:US
Practice Address - Phone:270-943-8202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13338363LF0000X
KY3004566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10350I0957Medicare UPIN