Provider Demographics
NPI:1801807615
Name:SCHLICK, SHARON AGNES (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:AGNES
Last Name:SCHLICK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E ASH ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32347
Mailing Address - Country:US
Mailing Address - Phone:850-584-3278
Mailing Address - Fax:850-584-8171
Practice Address - Street 1:315 E ASH ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32347
Practice Address - Country:US
Practice Address - Phone:850-584-3278
Practice Address - Fax:850-584-8171
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101642363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9101642OtherSTATE LICENSE NUMBER