Provider Demographics
NPI:1487099396
Name:FENNIMORE, SHARON (MA, E-RYT, RPYT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:FENNIMORE
Suffix:
Gender:F
Credentials:MA, E-RYT, RPYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 81061
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-0561
Mailing Address - Country:US
Mailing Address - Phone:412-855-5692
Mailing Address - Fax:
Practice Address - Street 1:3701 BUTLER ST
Practice Address - Street 2:C/O SHINING LIGHT DOULAS
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-1847
Practice Address - Country:US
Practice Address - Phone:412-855-5692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula