Provider Demographics
NPI:1588079552
Name:SHARKEY-WELLS, TRACI (CNP)
Entity type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:
Last Name:SHARKEY-WELLS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6785 W 130TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-7817
Mailing Address - Country:US
Mailing Address - Phone:440-843-8888
Mailing Address - Fax:440-843-8887
Practice Address - Street 1:6785 W 130TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-7817
Practice Address - Country:US
Practice Address - Phone:440-843-8888
Practice Address - Fax:440-843-8887
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2015-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16070-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner