Provider Demographics
NPI:1831277755
Name:SHARPE, STEPHEN ERIK (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ERIK
Last Name:SHARPE
Suffix:
Gender:M
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 1:107 GLEN OAK BLVD.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3162
Mailing Address - Country:US
Mailing Address - Phone:615-822-2400
Mailing Address - Fax:615-822-6941
Practice Address - Street 1:107 GLEN OAK BLVD.
Practice Address - Street 2:SUITE 201
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3162
Practice Address - Country:US
Practice Address - Phone:615-822-2400
Practice Address - Fax:615-822-9641
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1464363A00000X
TNPA0000001464363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN36648610Medicare PIN
TNQ74329Medicare UPIN