Provider Demographics
NPI:1043265176
Name:FEY, SHARON K (PA C)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:K
Last Name:FEY
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1444
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51102
Mailing Address - Country:US
Mailing Address - Phone:712-255-7746
Mailing Address - Fax:712-255-0829
Practice Address - Street 1:700 4TH STREET
Practice Address - Street 2:STE 410
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101
Practice Address - Country:US
Practice Address - Phone:712-255-7746
Practice Address - Fax:712-255-0829
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001658207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098555001Medicare PIN
Q78180Medicare UPIN
IAI19906Medicare PIN