Provider Demographics
NPI:1245866904
Name:SHARP, ELIANE LERIAS (PT)
Entity type:Individual
Prefix:
First Name:ELIANE
Middle Name:LERIAS
Last Name:SHARP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 KNOB CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-5024
Mailing Address - Country:US
Mailing Address - Phone:615-944-6833
Mailing Address - Fax:
Practice Address - Street 1:131 SAUNDERSVILLE RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-8903
Practice Address - Country:US
Practice Address - Phone:616-826-6612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3129225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty