Provider Demographics
NPI:1801608401
Name:ROTH, SHARON (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:ROTH
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 ASTER AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2632
Mailing Address - Country:US
Mailing Address - Phone:302-757-6255
Mailing Address - Fax:
Practice Address - Street 1:918 ASTER AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-2632
Practice Address - Country:US
Practice Address - Phone:302-757-6255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0041025163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse