Provider Demographics
NPI:1174984991
Name:SIAW, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SIAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3312
Mailing Address - Country:US
Mailing Address - Phone:917-383-6531
Mailing Address - Fax:430-249-0413
Practice Address - Street 1:1425 E DUBLIN GRANVILLE RD STE 111
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3312
Practice Address - Country:US
Practice Address - Phone:917-383-6531
Practice Address - Fax:430-249-0413
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0035507363L00000X
OHF07230180163W00000X
NY709597163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse