Provider Demographics
NPI:1003224650
Name:SPETHMAN, SHARON E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:E
Last Name:SPETHMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:E
Other - Last Name:FOURNIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7601 PIONEERS BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-4675
Mailing Address - Country:US
Mailing Address - Phone:402-484-6677
Mailing Address - Fax:402-484-4476
Practice Address - Street 1:1500 U ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68588-1281
Practice Address - Country:US
Practice Address - Phone:402-472-5000
Practice Address - Fax:402-472-8010
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1830363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant