Provider Demographics
NPI:1043880867
Name:WHITE, SHARRON ELEASE (BSN, RN, CCM)
Entity type:Individual
Prefix:
First Name:SHARRON
Middle Name:ELEASE
Last Name:WHITE
Suffix:
Gender:F
Credentials:BSN, RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28552 ORCHARD LAKE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2922
Mailing Address - Country:US
Mailing Address - Phone:248-539-1500
Mailing Address - Fax:248-539-1502
Practice Address - Street 1:28552 ORCHARD LAKE RD STE 100
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2922
Practice Address - Country:US
Practice Address - Phone:248-539-1500
Practice Address - Fax:248-539-1502
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704184491163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management