Provider Demographics
NPI:1952737405
Name:TUNSTALL, SHARON ELAINE (RRT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ELAINE
Last Name:TUNSTALL
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5976 HOMESTEAD CIR
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-1367
Mailing Address - Country:US
Mailing Address - Phone:678-284-1779
Mailing Address - Fax:
Practice Address - Street 1:5976 HOMESTEAD CIR
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-1367
Practice Address - Country:US
Practice Address - Phone:678-284-1779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5857227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered