Provider Demographics
NPI:1164480281
Name:KUPERSMITH, SHEILA CHRISTENSON (FNP - BC)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:CHRISTENSON
Last Name:KUPERSMITH
Suffix:
Gender:F
Credentials:FNP - BC
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Mailing Address - Street 1:1626 BEAMREACH PL
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-6743
Mailing Address - Country:US
Mailing Address - Phone:970-682-0465
Mailing Address - Fax:844-726-8896
Practice Address - Street 1:401 MASON CT.
Practice Address - Street 2:#101
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524
Practice Address - Country:US
Practice Address - Phone:970-829-0077
Practice Address - Fax:844-726-8896
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI937363LF0000X
COAPN0991742-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIS48078Medicare UPIN