Provider Demographics
NPI:1952400889
Name:THORNTON, SHARON E (FNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:E
Last Name:THORNTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 N UNION ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-2736
Mailing Address - Country:US
Mailing Address - Phone:716-701-6881
Mailing Address - Fax:716-701-6854
Practice Address - Street 1:9864 LUCKEY DR
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:NY
Practice Address - Zip Code:14744-8706
Practice Address - Country:US
Practice Address - Phone:716-375-7500
Practice Address - Fax:716-701-6898
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02168981Medicaid
NYS57174Medicare UPIN
NY02168981Medicaid