Provider Demographics
NPI:1215618806
Name:SHARP, ANNA CLAIR (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CLAIR
Last Name:SHARP
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14089 NEW ZION RD
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL SPGS
Mailing Address - State:MS
Mailing Address - Zip Code:39059-9386
Mailing Address - Country:US
Mailing Address - Phone:601-500-0198
Mailing Address - Fax:
Practice Address - Street 1:3531 LAKELAND DR STE 1060
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8016
Practice Address - Country:US
Practice Address - Phone:601-420-5810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906138363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health