Provider Demographics
NPI:1174902928
Name:MORAVEC, SHARLYN (FNP-BC)
Entity type:Individual
Prefix:
First Name:SHARLYN
Middle Name:
Last Name:MORAVEC
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 7TH ST SW
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55964-1173
Mailing Address - Country:US
Mailing Address - Phone:507-696-2295
Mailing Address - Fax:
Practice Address - Street 1:2786 FAIRVIEW AVE N
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1306
Practice Address - Country:US
Practice Address - Phone:763-412-1993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 128583-7363LF0000X
MN3837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily