Provider Demographics
NPI:1124454681
Name:SHARPER, ROSELLAR (CNA / MA)
Entity type:Individual
Prefix:
First Name:ROSELLAR
Middle Name:
Last Name:SHARPER
Suffix:
Gender:F
Credentials:CNA / MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3341 GROVE CRABTREE CRES
Mailing Address - Street 2:APT. 533
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3069
Mailing Address - Country:US
Mailing Address - Phone:919-641-2966
Mailing Address - Fax:
Practice Address - Street 1:3341 GROVE CRABTREE CRES
Practice Address - Street 2:APT. 533
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-3069
Practice Address - Country:US
Practice Address - Phone:919-641-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC120476374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide