Provider Demographics
NPI:1235623901
Name:SHARPE CONCIERGE HEALTHCARE LLC
Entity type:Organization
Organization Name:SHARPE CONCIERGE HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCKELTON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:561-632-0666
Mailing Address - Street 1:302 HARBOUR POINTE WAY
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413
Mailing Address - Country:US
Mailing Address - Phone:561-632-0666
Mailing Address - Fax:
Practice Address - Street 1:302 HARBOUR POINTE WAY
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413
Practice Address - Country:US
Practice Address - Phone:561-632-0666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WW0000X, 363LF0000X
FL251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care