Provider Demographics
NPI:1841291713
Name:MUSE, SHARON B (NP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:B
Last Name:MUSE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 NEWNAN RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30116-6428
Mailing Address - Country:US
Mailing Address - Phone:770-836-6667
Mailing Address - Fax:
Practice Address - Street 1:1004 NEWNAN RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30116-6428
Practice Address - Country:US
Practice Address - Phone:770-836-6667
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN060123 NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00530208AMedicaid