Provider Demographics
NPI:1740979632
Name:NAUTA, SHARON R (RN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:R
Last Name:NAUTA
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 1:3419 KESWICK DR NE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49306-9103
Mailing Address - Country:US
Mailing Address - Phone:616-240-7218
Mailing Address - Fax:
Practice Address - Street 1:3419 KESWICK DR NE
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MI
Practice Address - Zip Code:49306-9103
Practice Address - Country:US
Practice Address - Phone:616-240-7218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704159281163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse