Provider Demographics
NPI:1881877744
Name:HOMAN, SHARON LYNNE (PAC)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LYNNE
Last Name:HOMAN
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:PANKOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34990
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0627
Mailing Address - Country:US
Mailing Address - Phone:610-359-5672
Mailing Address - Fax:833-941-3871
Practice Address - Street 1:283 SECOND STREET PIKE STE 120
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3823
Practice Address - Country:US
Practice Address - Phone:855-678-4627
Practice Address - Fax:833-941-3871
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053184363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA120194LJYMedicare PIN