Provider Demographics
NPI:1104908698
Name:KRIEGER, SHARON M (MS, APRN)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:M
Last Name:KRIEGER
Suffix:
Gender:F
Credentials:MS, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33920 US 19 N STE 170
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2619
Mailing Address - Country:US
Mailing Address - Phone:727-781-1000
Mailing Address - Fax:727-330-7551
Practice Address - Street 1:33920 US 19 N STE 170
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2619
Practice Address - Country:US
Practice Address - Phone:727-781-1000
Practice Address - Fax:727-330-7551
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL879732163WG0000X, 363LF0000X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN879732OtherARNP LISCENSE
FL034203300Medicaid
FLRN879732OtherARNP LISCENSE
FL034203300Medicaid
FLY3411BMedicare PIN