Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | ME38621 | FL |
NPI | 1407076052 |
---|---|
Provider Name | Dr. Sharon Ann Nickell-Olm |
First Address | Eustis, FL 32726-6149 |
Second Address | Eustis, FL 32726-6149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 28/03/2018 |