Basic Information
| Provider Information | |||||||||
| NPI: | 1336162239 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEINRICH | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | LOUISE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3984 | ||||||||
| Address2: | GASTON HOSPICE | ||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280540040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048618405 | ||||||||
| FaxNumber: | 7048650590 | ||||||||
| Practice Location | |||||||||
| Address1: | 258 E GARRISON BLVD | ||||||||
| Address2: | GASTON HOSPICE | ||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280540460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048618405 | ||||||||
| FaxNumber: | 7048650590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 07/17/2012 | ||||||||
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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 | 163W00000X | 148711 | NC | N | Nursing Service Providers | Registered Nurse | 363L00000X | 200843 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 200843 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.