Provider Demographics
NPI:1841969193
Name:DRISKELL, SHARON RENEE (BSN)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:RENEE
Last Name:DRISKELL
Suffix:
Gender:F
Credentials:BSN
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 66
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:LA
Mailing Address - Zip Code:71373-0066
Mailing Address - Country:US
Mailing Address - Phone:833-782-2253
Mailing Address - Fax:318-232-6932
Practice Address - Street 1:806 CARTER STREET
Practice Address - Street 2:SUITE B
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373
Practice Address - Country:US
Practice Address - Phone:833-782-2253
Practice Address - Fax:318-232-6932
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC189280163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics