Provider Demographics
NPI:1124778345
Name:SHARON PHILBIN FAMILY NURSE PRACTITIONER. LLC
Entity type:Organization
Organization Name:SHARON PHILBIN FAMILY NURSE PRACTITIONER. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILBIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:401-474-4212
Mailing Address - Street 1:100 LAFAYETTE ST # 302
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6008
Mailing Address - Country:US
Mailing Address - Phone:401-632-6555
Mailing Address - Fax:401-475-4112
Practice Address - Street 1:100 LAFAYETTE ST # 302
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6008
Practice Address - Country:US
Practice Address - Phone:401-475-4212
Practice Address - Fax:401-475-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty