Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NN03666900 | NJ |
NPI | 1023231438 |
---|---|
Provider Name | Mary Ann M Sharpe |
First Address | Westfield, NJ 07090-2628 |
Second Address | Montclair, NJ 07043-1624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |