Provider Demographics
NPI:1649437823
Name:HYDO, SHARON KAY (RN)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:KAY
Last Name:HYDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W14721 OLD HIGHWAY 10
Mailing Address - Street 2:
Mailing Address - City:FAIRCHILD
Mailing Address - State:WI
Mailing Address - Zip Code:54741-8843
Mailing Address - Country:US
Mailing Address - Phone:715-334-1514
Mailing Address - Fax:
Practice Address - Street 1:500 E VETERANS ST
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-3105
Practice Address - Country:US
Practice Address - Phone:608-372-1176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI72850030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse