Sharon Mack Derstine, ARNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

AP30005738 Issued in WA

Practice address

1106 E 1St St
Port Angeles, WA 98362-4317

Phone

(360) 452-2954

Fax

(360) 457-7683

NPI assigned

Sep 1, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Planning of Clallam County

  • Specialist
  • Forks, WA
  • NPI 1417170820
  NPD (past)
• Family Planning of Clallam County

  • Specialist
  • Port Angeles, WA
  • NPI 1548391964
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1104810480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983624317",
            "telephone_number": "360-452-2954",
            "fax_number": "360-457-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983624317",
            "telephone_number": "360-452-2954",
            "fax_number": "360-457-7683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERSTINE",
        "first_name": "SHARON",
        "middle_name": "MACK",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-01",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WA",
            "license": "AP30005738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas L Demoss, DMD
• Caleb Demott
• Isabelle Dennis
• Danielle A. Deoliveira, PMHNP-BC
• Margaret M Depew, ARNP
• Alisha N Detorres, ND
• Michael John Devoney, LAC.
• Donna Dewey-Osborne, LPN
• Patrick Dewitt, COTA
• Darcy Deyling, LMHC-A

• Women's Health Nurse Practitioner in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Women's Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.