Provider Demographics
NPI:1942693387
Name:SHARKEY, DEVON DONNELLY (APRN, AGNP-C)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:DONNELLY
Last Name:SHARKEY
Suffix:
Gender:F
Credentials:APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211699
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-3699
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-973-8821
Practice Address - Street 1:3623 CROSSINGS DR STE 206
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7101
Practice Address - Country:US
Practice Address - Phone:866-849-0692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36841363LA2200X
OHAPRN.CNP.0036345363LA2200X
FLTPAN2508363LA2200X
TX1178130363LA2200X
MS907077363LA2200X
NC5021381363LA2200X
IL209031807363LA2200X
AZ299001363LA2200X
OR10023812363LA2200X
COC-APN.0101829-C-NP363LA2200X
WAAP61606210363LA2200X
AL3-001989363LA2200X
KY4025978363LA2200X
AR230926363LA2200X
SC19341363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP3600Medicaid
SCSC71347951Medicare PIN