Provider Demographics
NPI:1982897435
Name:CHILDS, SHARON ANN (MS, APRN-BC, NP/CS)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANN
Last Name:CHILDS
Suffix:
Gender:F
Credentials:MS, APRN-BC, NP/CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WHITE SPRUCE CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1514
Mailing Address - Country:US
Mailing Address - Phone:410-661-3538
Mailing Address - Fax:410-661-8104
Practice Address - Street 1:13 WHITE SPRUCE CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-1514
Practice Address - Country:US
Practice Address - Phone:410-661-3538
Practice Address - Fax:410-661-8104
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-18
Last Update Date:2007-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO59440363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS 69493Medicare UPIN