Individual
ANDREA BETH SHARKNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 TRUMANSBURG RD, SUITE H, ITHACA, NY 14850-1397
(607) 272-6880
Mailing address
1301 TRUMANSBURG RD, SUITE H, ITHACA, NY 14850-1397
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F382070-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03248446
—
NY
Enumeration date
07/22/2010
Last updated
10/05/2012
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