Provider Demographics
NPI:1487241956
Name:SHARP, ABIGAIL LEE (ARNP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LEE
Last Name:SHARP
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 1:405 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-1928
Mailing Address - Country:US
Mailing Address - Phone:641-753-2752
Mailing Address - Fax:641-753-6450
Practice Address - Street 1:405 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-1928
Practice Address - Country:US
Practice Address - Phone:641-753-2752
Practice Address - Fax:641-753-6450
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA147640163W00000X
IAA162438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1487241956OtherUNKNOWN