Provider Demographics
NPI:1992487003
Name:SHARRETT, ELIZABETH (FNTP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SHARRETT
Suffix:
Gender:F
Credentials:FNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 VEECHDALE RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40067-7632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:784 VEECHDALE RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:KY
Practice Address - Zip Code:40067-7632
Practice Address - Country:US
Practice Address - Phone:502-643-6253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4644171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach