Provider Demographics
NPI:1982747481
Name:PEABODY, SHARON M (FNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:PEABODY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:M
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:12601 TURKS TURN ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-3311
Mailing Address - Country:US
Mailing Address - Phone:907-345-6819
Mailing Address - Fax:
Practice Address - Street 1:12601 TURKS TURN ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99516-3311
Practice Address - Country:US
Practice Address - Phone:907-345-6819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK134363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily