Provider Demographics
NPI:1366408171
Name:BOTTOMLEY, SHARON RUTH (MSN, RN, ANP-BC)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:RUTH
Last Name:BOTTOMLEY
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Gender:F
Credentials:MSN, RN, ANP-BC
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Mailing Address - Street 1:1970 ROANOKE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6404
Mailing Address - Country:US
Mailing Address - Phone:540-982-2463
Mailing Address - Fax:540-224-1937
Practice Address - Street 1:1970 ROANOKE BOULEVARD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6404
Practice Address - Country:US
Practice Address - Phone:540-982-2463
Practice Address - Fax:540-224-1937
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2012-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024145861363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health