Provider Demographics
NPI:1104980325
Name:THOMPSON, SHARON YVONNE
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:YVONNE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:YVONNE
Other - Last Name:CONNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7384 W COLTER ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85303
Mailing Address - Country:US
Mailing Address - Phone:623-848-6049
Mailing Address - Fax:623-848-6049
Practice Address - Street 1:7384 W COLTER ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85303
Practice Address - Country:US
Practice Address - Phone:623-848-6049
Practice Address - Fax:623-848-6049
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17363747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider