Provider Demographics
NPI:1356062236
Name:PEEBLES, SHARON DENISE (FNP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:DENISE
Last Name:PEEBLES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:PEEBLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:125B VICTORY DR
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-3234
Mailing Address - Country:US
Mailing Address - Phone:478-419-1250
Mailing Address - Fax:478-419-1252
Practice Address - Street 1:125B VICTORY DR
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3234
Practice Address - Country:US
Practice Address - Phone:478-419-1250
Practice Address - Fax:478-419-1252
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN150025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily