Provider Demographics
NPI:1336683796
Name:ZELL, SHARON KAYE (ARNP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:KAYE
Last Name:ZELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S WHITE MOUNTAIN RD STE 401B
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-7117
Mailing Address - Country:US
Mailing Address - Phone:289-251-2914
Mailing Address - Fax:877-569-3330
Practice Address - Street 1:1500 S WHITE MOUNTAIN RD STE 401B
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7117
Practice Address - Country:US
Practice Address - Phone:928-251-2914
Practice Address - Fax:877-569-3330
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60711956363LF0000X
AZ265407363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ265407OtherAZ BON
WAAP 60711956OtherWA STATE DOH
ORC367046OtherOR DOL