DR. SHARA SMITH BLEDSOE (NPI# 1063776607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063776607 |
| Entity Type | Individual |
| Full Name | DR. SHARA SMITH BLEDSOE |
| Credential | FNP-C |
| Practice Address |
12425 Crossroads Dr Olive Branch MS 38654 |
| Mailing Address |
12425 Crossroads Drive Olive Branch MS 38654 |
| Practice Telephone | 6624681300 |
| Practice Fax Number | 6624701952 |
| Mailing Telephone | 6624681300 |
| Mailing Fax Number | 6624701952 |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2019-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R874322 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09028791 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1502 S Colorado St, Greenville, MS 387037219 | 6623346448 | 6623346461 |
| Street Address |
12425 CROSSROADS DR |
| City | OLIVE BRANCH |
| State | MS |
| Zip Code | 38654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093366213 | Latonya Shontae Binion | Home Health | 5915 Brice Cove North, Olive Branch, MS 38654 | 2019-09-28 |
| 1356828677 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 688 Goodman Rd, Ste 123, Olive Branch, MS 38654 | 2018-07-20 |
| 1629565684 | Alexis Summerville Mcdavis | Pharmacist | 7950 Craft Goodman Frontage Rd, Olive Branch, MS 38654 | 2018-04-16 |
| 1194237206 | Exos Physical Therapy and Sports Medicine, LLC | Physical Therapist | 6542 Goodman Rd, Olive Branch, MS 38654 | 2017-10-30 |
| 1609386515 | Laken Hood Richardson | Physical Therapist | 9085 East Sandidge Cove, Suite 250, Olive Branch, MS 38654 | 2017-10-05 |
| 1275064255 | Heart of Hospice, LLC | Hospice Care, Community Based | 9849 Highway 178 Unit B, Olive Branch, MS 38654 | 2017-03-22 |
| 1023557865 | Michael Patrick Mccallum | Counselor | 9320 Railroad Ave., Olive Branch, MS 38654 | 2017-02-13 |
| 1891179768 | Desoto Children's Clinic - Olive Branch | Pediatrics | 7145 Goodman Road, Olive Branch, MS 38654 | 2015-07-10 |
| 1891185203 | Kristina Harper | Midwife | 9086 Pigeon Roost Rd Ste C, Olive Branch, MS 38654 | 2015-01-23 |
| 1275955098 | Global Medical | Durable Medical Equipment & Medical Supplies | 6229 Hwy 305 Ste L, Olivebranch, MS 38654 | 2014-01-14 |
| Find all providers in zip 38654 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199523 | Kenyatta Cowains | Nurse Practitioner | 9400 Goodman Rd Apt 3704, Olive Branch, MS 38654-1979 | 2020-09-17 |
| 1316559479 | Dimpleben Vikalp Patel | Nurse Practitioner | 4735 Robinson Loop W, Olive Branch, MS 38654-8175 | 2020-08-20 |
| 1548872526 | Julina Henderson | Nurse Practitioner | 3498 Cypress Plantation Dr, Olive Branch, MS 38654-6142 | 2020-08-20 |
| 1326682600 | Bonnie F Dering | Nurse Practitioner | 6674 Goodman Rd, Olive Branch, MS 38654-7056 | 2019-10-30 |
| 1588137541 | Latonia Williams | Nurse Practitioner | 8093 Falcon Dr, Olive Branch, MS 38654-5619 | 2019-01-02 |
| 1215418439 | Roslyn Raquel Perry | Nurse Practitioner | 4213 Ritchie Dr, Olive Branch, MS 38654-6766 | 2018-08-25 |
| 1528599602 | Angelette Nichol Sykes | Nurse Practitioner | 10651 Cali Cv, Olive Branch, MS 38654-9551 | 2017-03-21 |
| 1669916151 | Karen Denise Buchanan | Nurse Practitioner | 562 Duram Rd, Olive Branch, MS 38654-6819 | 2016-12-19 |
| 1538619093 | Kristina Murphy | Nurse Practitioner | 8807 Turkey Creek Dr, Olive Branch, MS 38654-9813 | 2016-10-09 |
| 1386190627 | Shelly L Flowers | Nurse Practitioner | 9075 E Sandidge Center Cove, Olive Branch, MS 38654-3514 | 2016-08-28 |
| Find all providers in OLIVE BRANCH | ||||
| City | OLIVE BRANCH |
| Zip Code | 38654 |
Please comment or provide details below to improve the information on DR. SHARA SMITH BLEDSOE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.