Provider Demographics
NPI:1841809761
Name:FERNANDEZ, SHARON MCKNIGHT (LPN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:MCKNIGHT
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1130
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:LA
Mailing Address - Zip Code:70754-1130
Mailing Address - Country:US
Mailing Address - Phone:225-686-7044
Mailing Address - Fax:
Practice Address - Street 1:13909 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:LA
Practice Address - Zip Code:70754-6340
Practice Address - Country:US
Practice Address - Phone:225-686-7044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA210109164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse