Provider Demographics
NPI:1477723138
Name:GRANTHAM, SHARON L (ARNP-BC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:L
Last Name:GRANTHAM
Suffix:
Gender:F
Credentials:ARNP-BC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:L
Other - Last Name:HAPPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FT. MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-1400
Mailing Address - Fax:239-424-1421
Practice Address - Street 1:16410 HEALTHPARK COMMONS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-9621
Practice Address - Country:US
Practice Address - Phone:239-343-9777
Practice Address - Fax:239-343-9789
Is Sole Proprietor?:No
Enumeration Date:2008-03-08
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 3013362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily