Provider Demographics
NPI:1609857762
Name:SPARLING, DIAN RACHEL (CNM, MSN)
Entity Type:Individual
Prefix:
First Name:DIAN
Middle Name:RACHEL
Last Name:SPARLING
Suffix:
Gender:F
Credentials:CNM, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3930
Mailing Address - Country:US
Mailing Address - Phone:970-493-1865
Mailing Address - Fax:970-493-1586
Practice Address - Street 1:1025 GARFIELD ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3930
Practice Address - Country:US
Practice Address - Phone:970-493-1865
Practice Address - Fax:970-493-1586
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO68382176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07683824Medicaid
2221OtherACNM
CO68382OtherRN LICENSE
MS0632287OtherDEA
CO07683824Medicaid
E4023Medicare ID - Type Unspecified