Provider Demographics
NPI:1649005547
Name:BEAUTZ, SHARON GERETTE (RN, CNS)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:GERETTE
Last Name:BEAUTZ
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15704 ANCIENT OAK DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3516
Mailing Address - Country:US
Mailing Address - Phone:202-445-6823
Mailing Address - Fax:
Practice Address - Street 1:15704 ANCIENT OAK DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-3516
Practice Address - Country:US
Practice Address - Phone:202-445-6823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCS00126364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist