Provider Demographics
NPI:1194483255
Name:KATNER, SHARON MARY (RN)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MARY
Last Name:KATNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 VISTA OESTE NW # 2
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3693
Mailing Address - Country:US
Mailing Address - Phone:360-310-7550
Mailing Address - Fax:928-697-4083
Practice Address - Street 1:HIGHWAY 160
Practice Address - Street 2:163 BUILDING
Practice Address - City:KAYENTA
Practice Address - State:AZ
Practice Address - Zip Code:86033
Practice Address - Country:US
Practice Address - Phone:928-697-4202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR40335163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management