Provider Demographics
NPI:1457374456
Name:VANOVER, SHARON GALE (APN)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:GALE
Last Name:VANOVER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 FELDSPAR CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2108
Mailing Address - Country:US
Mailing Address - Phone:501-257-6707
Mailing Address - Fax:501-257-6606
Practice Address - Street 1:4300 W 7TH ST
Practice Address - Street 2:112EY/LR
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5446
Practice Address - Country:US
Practice Address - Phone:501-257-6707
Practice Address - Fax:501-257-6606
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAO1209363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care