Individual
MRS. SHARON FREEMAN CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, MSN, PMHCNS-BC
Contact information
Practice address
423 AIRPORT NORTH OFFICE PARK, FORT WAYNE, IN 46825-6704
(260) 969-5583
(260) 969-5584
Mailing address
423 AIRPORT NORTH OFFICE PARK, FORT WAYNE, IN 46825-6704
(260) 969-5583
(260) 969-5584
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
70000153A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1612
PHP
IN
Enumeration date
06/10/2005
Last updated
11/26/2014
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