Provider Demographics
NPI:1144352972
Name:SHARP, NINA MARIE (INDEPENDANT PROVIDER)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:MARIE
Last Name:SHARP
Suffix:
Gender:F
Credentials:INDEPENDANT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10418 STATE ROUTE 775
Mailing Address - Street 2:
Mailing Address - City:SCOTTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45678-8947
Mailing Address - Country:US
Mailing Address - Phone:740-643-2872
Mailing Address - Fax:
Practice Address - Street 1:350 TOWNSHIP ROAD 113
Practice Address - Street 2:
Practice Address - City:PEDRO
Practice Address - State:OH
Practice Address - Zip Code:45659-9000
Practice Address - Country:US
Practice Address - Phone:740-532-4785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2592869376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide