Provider Demographics
NPI:1588103931
Name:PEARCY, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:PEARCY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 WATERFALL WAY
Mailing Address - Street 2:UNIT 101
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-6860
Mailing Address - Country:US
Mailing Address - Phone:203-988-7072
Mailing Address - Fax:
Practice Address - Street 1:185 WATERFALL WAY
Practice Address - Street 2:UNIT 101
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-6860
Practice Address - Country:US
Practice Address - Phone:203-988-7072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9286814363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care