Basic Information
| Provider Information | |||||||||
| NPI: | 1972159952 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHARP | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | JACOB | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8841 W DIGGER LN | ||||||||
| Address2: | |||||||||
| City: | MAGNA | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840442720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8018978144 | ||||||||
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| Practice Location | |||||||||
| Address1: | 389 S 900 E | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841022310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3852822000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2019 | ||||||||
| LastUpdateDate: | 08/14/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | PENDING | UT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.