Provider Demographics
NPI:1932532330
Name:EDWARDS, SHARON (RN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WILCOCK ST APT 1
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2723
Mailing Address - Country:US
Mailing Address - Phone:617-780-2654
Mailing Address - Fax:
Practice Address - Street 1:529 MAIN STREET
Practice Address - Street 2:SUITE 216
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129
Practice Address - Country:US
Practice Address - Phone:617-600-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2270413163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care