Provider Demographics
NPI:1770985442
Name:SHARBEL, CHRISTY E (PA)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:E
Last Name:SHARBEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:E
Other - Last Name:ANSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3736 MIKE PADGETT HWY STE A
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-0720
Mailing Address - Country:US
Mailing Address - Phone:706-560-2273
Mailing Address - Fax:
Practice Address - Street 1:3736 MIKE PADGETT HWY STE A
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-0720
Practice Address - Country:US
Practice Address - Phone:706-560-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN363A00000X
GA7947363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ009050Medicaid
TN103I975454Medicare PIN