Provider Demographics
NPI:1235984121
Name:COLLINS, SHARON KAY
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:KAY
Last Name:COLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SHERATON DR NW APT 8
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2266
Mailing Address - Country:US
Mailing Address - Phone:234-237-6748
Mailing Address - Fax:
Practice Address - Street 1:123 SHERATON DR NW APT 8
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-2266
Practice Address - Country:US
Practice Address - Phone:234-237-6748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant