Basic Information
| Provider Information | |||||||||
| NPI: | 1740211937 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRUMBLEY | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | G. | ||||||||
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| Credential: | WHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 70403 | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376141703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234394078 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1901 S SHADY ST | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376832021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237271150 | ||||||||
| FaxNumber: | 4237271152 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 01/31/2008 | ||||||||
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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 | 363LW0102X | APN006383 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | JOHN DEERE | 01 | TN | TN01C3 | OTHER | 133278 | 01 | TN | BLUECROSSBLUESHIELD | OTHER | 3908051 | 05 | TN | MEDICAID | 100036752 | 01 | TN | PHP | OTHER |