Provider Demographics
NPI:1184171431
Name:SHARP, HEATHER (APRN)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1508
Mailing Address - Country:US
Mailing Address - Phone:330-759-1685
Mailing Address - Fax:
Practice Address - Street 1:1391 W 5TH AVE
Practice Address - Street 2:STE 260
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2902
Practice Address - Country:US
Practice Address - Phone:844-326-3119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-03
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016435363LF0000X
OHAPRN.CNP.019619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily