Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN175411 | GA |
N | 363LG0600X | Nurse Practitioner - Gerontology | RN175411 | GA |
NPI | 1073015384 |
---|---|
Provider Name | Sharon Michelle Holbrook |
First Address | Rome, GA 30161-4720 |
Second Address | Calhoun, GA 30701-9408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2018 |
Last Update Date | 17/03/2018 |