Provider Demographics
NPI:1851135115
Name:MCKEETHEN, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:MCKEETHEN
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 1:2127 HARTSUFF ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-2255
Mailing Address - Country:US
Mailing Address - Phone:989-992-9927
Mailing Address - Fax:
Practice Address - Street 1:2715 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-3870
Practice Address - Country:US
Practice Address - Phone:989-412-9467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care