Provider Demographics
NPI:1487104949
Name:SHARPE, STEPHANIE ANN (NP-C)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ANN
Last Name:SHARPE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43145 SCHOENHERR RD UNIT 13
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1955
Mailing Address - Country:US
Mailing Address - Phone:586-997-5048
Mailing Address - Fax:586-997-5049
Practice Address - Street 1:43145 SCHOENHERR RD UNIT 13
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1955
Practice Address - Country:US
Practice Address - Phone:586-997-5048
Practice Address - Fax:586-997-5049
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-09
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704272224363LF0000X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily