Basic Information
| Provider Information | |||||||||
| NPI: | 1265528301 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHARP | ||||||||
| FirstName: | RACHAEL | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FLOWERS-LEE | ||||||||
| OtherFirstName: | RACHAEL | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CRNA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 108 PRETTY MARSH RD | ||||||||
| Address2: | |||||||||
| City: | MOUNT DESERT | ||||||||
| State: | ME | ||||||||
| PostalCode: | 046606112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072885081 | ||||||||
| FaxNumber: | 2072887024 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 WAYMAN LN | ||||||||
| Address2: | MOUNT DESERT ISLAND HOSPITAL | ||||||||
| City: | BAR HARBOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 046091625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072885081 | ||||||||
| FaxNumber: | 2072887024 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 03/07/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | R038265 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | R038265 | 01 | ME | LICENSE | OTHER |