Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 21906 | TN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 21906 | TN |
NPI | 1487104238 |
---|---|
Provider Name | Angela Cavanaugh Sharp |
First Address | Nashville, TN 37203-1538 |
Second Address | Cookeville, TN 38501-4294 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2016 |
Last Update Date | 04/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6081577 | BCBS (01) | TN |
7100445980 | (05) | KY |
Q024691 | (05) | TN |