Provider Demographics
NPI:1700140985
Name:FENLON, SHARON ANN I
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:FENLON
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5913 GRABURNS FORD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-7121
Mailing Address - Country:US
Mailing Address - Phone:704-948-8127
Mailing Address - Fax:
Practice Address - Street 1:5913 GRABURNS FORD DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7121
Practice Address - Country:US
Practice Address - Phone:704-948-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor