Provider Demographics
NPI:1871088401
Name:SHARP, TAMARA D (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:D
Last Name:SHARP
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 E MONONA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-4150
Mailing Address - Country:US
Mailing Address - Phone:480-703-5355
Mailing Address - Fax:
Practice Address - Street 1:1515 E MISSOURI AVE STE 201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2432
Practice Address - Country:US
Practice Address - Phone:602-234-3733
Practice Address - Fax:602-253-1631
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11084363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health