Provider Demographics
NPI:1366251316
Name:AGENMONMEN, SHARON EDE (PMHNP-BC)
Entity type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:EDE
Last Name:AGENMONMEN
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 1:3085 WALNUT BEND LN APT 25
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-3328
Mailing Address - Country:US
Mailing Address - Phone:908-422-2960
Mailing Address - Fax:
Practice Address - Street 1:2412 OLD NORTH RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-1548
Practice Address - Country:US
Practice Address - Phone:908-422-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030398363LP0808X
TX1159517363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health