Provider Demographics
NPI:1811329204
Name:BENTON, SHARON CHRISTINA (RN, NNP-BC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:CHRISTINA
Last Name:BENTON
Suffix:
Gender:F
Credentials:RN, NNP-BC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:CHRISTINA
Other - Last Name:BATEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 W PONCE DE LEON AVE
Mailing Address - Street 2:#242
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2542
Mailing Address - Country:US
Mailing Address - Phone:404-778-7622
Mailing Address - Fax:
Practice Address - Street 1:101 W PONCE DE LEON AVE
Practice Address - Street 2:#242
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2542
Practice Address - Country:US
Practice Address - Phone:404-778-7622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN228053363LN0005X, 363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal