Provider Demographics
NPI:1740986223
Name:HENRY, SHARON COLLEEN (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:COLLEEN
Last Name:HENRY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 NE 158TH AVE
Mailing Address - Street 2:
Mailing Address - City:MAXWELL
Mailing Address - State:IA
Mailing Address - Zip Code:50161-4395
Mailing Address - Country:US
Mailing Address - Phone:515-419-1222
Mailing Address - Fax:515-699-5722
Practice Address - Street 1:3600 30TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5753
Practice Address - Country:US
Practice Address - Phone:515-699-5518
Practice Address - Fax:515-699-5722
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA110328163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse