Provider Demographics
NPI:1174897805
Name:BIRDSEYE, SHARON A (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:A
Last Name:BIRDSEYE
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 POWERS FERRY RD SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5011
Mailing Address - Country:US
Mailing Address - Phone:770-644-0555
Mailing Address - Fax:770-644-0514
Practice Address - Street 1:2024 POWERS FERRY RD SE
Practice Address - Street 2:SUITE 201
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5011
Practice Address - Country:US
Practice Address - Phone:770-644-0555
Practice Address - Fax:770-644-0514
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN027027163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse