Provider Demographics
NPI:1043274483
Name:HARMON, SHARON K (CRNA)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:K
Last Name:HARMON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:K
Other - Last Name:KENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4010 FISH HATCHERY RD
Mailing Address - Street 2:
Mailing Address - City:GASTON
Mailing Address - State:SC
Mailing Address - Zip Code:29053-9489
Mailing Address - Country:US
Mailing Address - Phone:808-218-4161
Mailing Address - Fax:
Practice Address - Street 1:1 WELLNESS BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2871
Practice Address - Country:US
Practice Address - Phone:843-839-5995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 3647367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered