Individual
MR. SAMUEL ANDREW SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF EMERGENCY MEDICINE, JACKSON, MS 39216
(601) 815-1781
Mailing address
2500 NORTH STATE STREET, UNIVERSITY PHYSICIANS, JACKSON, MS 39216-4500
(601) 984-5571
(601) 984-5583
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R880677
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03601094
—
MS
Enumeration date
10/04/2011
Last updated
02/24/2015
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