Provider Demographics
NPI:1811104151
Name:DONNERSON, SHARIE L (MHPP)
Entity type:Individual
Prefix:
First Name:SHARIE
Middle Name:L
Last Name:DONNERSON
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 CHERRY CT APT A
Mailing Address - Street 2:
Mailing Address - City:GOSNELL
Mailing Address - State:AR
Mailing Address - Zip Code:72315-3774
Mailing Address - Country:US
Mailing Address - Phone:870-532-6030
Mailing Address - Fax:
Practice Address - Street 1:1510 BYRUM RD
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-8033
Practice Address - Country:US
Practice Address - Phone:870-532-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator