Provider Demographics
NPI:1801922000
Name:SHARPE, CAROL ANN (TRANSPORTATION)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:SHARPE
Suffix:
Gender:F
Credentials:TRANSPORTATION
Other - Prefix:
Other - First Name:LIGHTNING
Other - Middle Name:YELLOW
Other - Last Name:TAXI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TRANSPORTATION
Mailing Address - Street 1:4295 N BENTON ST
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-2640
Mailing Address - Country:US
Mailing Address - Phone:928-692-9746
Mailing Address - Fax:928-692-0233
Practice Address - Street 1:4295 N BENTON ST
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-2640
Practice Address - Country:US
Practice Address - Phone:928-753-4444
Practice Address - Fax:928-692-0233
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07-2431344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi