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Individual
SHARON A REPIE TRENT-FULFORD
Active
Individual
SHARON A REPIE TRENT-FULFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26411
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1566241
LA - MEDICAID
LA
01
—
88651C
TX-BLUE SHIELD
—
Enumeration date
01/19/2007
Last updated
11/01/2007
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