Provider Demographics
NPI:1750433124
Name:STAGG, SHARON JENNINGS (MS, CRNP)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:JENNINGS
Last Name:STAGG
Suffix:
Gender:F
Credentials:MS, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7044 OLD SCHOOLHOUSE LN NUMBER 2
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-8391
Mailing Address - Country:US
Mailing Address - Phone:410-820-4740
Mailing Address - Fax:
Practice Address - Street 1:2 AURORA ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1912
Practice Address - Country:US
Practice Address - Phone:410-228-5511
Practice Address - Fax:410-228-0474
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR098969363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily