Provider Demographics
NPI:1942239728
Name:KNOX, SHARON P (FNPC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:P
Last Name:KNOX
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:K
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNPC
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:SIMPLY MEDICINE, PC.
Mailing Address - City:SAUTEE NACOOCHEE
Mailing Address - State:GA
Mailing Address - Zip Code:30571
Mailing Address - Country:US
Mailing Address - Phone:706-878-1814
Mailing Address - Fax:706-878-0051
Practice Address - Street 1:33 NACOOCHEE WAY
Practice Address - Street 2:SIMPLY MEDICINE, PC
Practice Address - City:SAUTEE NACOOCHEE
Practice Address - State:GA
Practice Address - Zip Code:30571
Practice Address - Country:US
Practice Address - Phone:706-878-1814
Practice Address - Fax:706-878-0051
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN060943363L00000X, 363LF0000X, 363LP2300X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA459895225CMedicaid
GAP00289329OtherRAILROAD MEDICARE
GA459895225CMedicaid
GAP18773Medicare UPIN
GAP18501Medicare UPIN