Provider Demographics
NPI:1861776890
Name:DAVIS, SHARON G (FNP-BC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:G
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:G
Other - Last Name:DINGESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 731
Mailing Address - Street 2:
Mailing Address - City:PECKS MILL
Mailing Address - State:WV
Mailing Address - Zip Code:25547-0731
Mailing Address - Country:US
Mailing Address - Phone:304-784-7231
Mailing Address - Fax:
Practice Address - Street 1:202 LARRY JOE HARLESS DR.
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:WV
Practice Address - Zip Code:25621-1842
Practice Address - Country:US
Practice Address - Phone:304-664-6270
Practice Address - Fax:304-664-6272
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51345363L00000X
KY3007210363LF0000X
WV63088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810025953Medicaid
WV002750753OtherHIGHMARK BCBS
WVWV2785HMedicare Oscar/Certification
WVWV2785DMedicare Oscar/Certification
WVWV2785CMedicare Oscar/Certification
WV002750753OtherHIGHMARK BCBS
WV3810025953Medicaid
WVWV2785B662Medicare Oscar/Certification
WVWV2785EMedicare Oscar/Certification
WVWV2785BMedicare Oscar/Certification
WVWV2785AMedicare Oscar/Certification
WVWV2785B663Medicare Oscar/Certification