Provider Demographics
NPI:1215703210
Name:SHARPE, BIANCA ROCHELLE
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:ROCHELLE
Last Name:SHARPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 CREEKBEND DR APT 47
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-1729
Mailing Address - Country:US
Mailing Address - Phone:850-759-2767
Mailing Address - Fax:
Practice Address - Street 1:7700 CREEKBEND DR APT 47
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-1729
Practice Address - Country:US
Practice Address - Phone:850-759-2767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
48124904172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver