Provider Demographics
NPI:1366117046
Name:BOULWARE, SHARNICE R (APRN)
Entity type:Individual
Prefix:DR
First Name:SHARNICE
Middle Name:R
Last Name:BOULWARE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:1595 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-5529
Practice Address - Country:US
Practice Address - Phone:843-212-8080
Practice Address - Fax:843-789-1521
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-13
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC24801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily