Provider Demographics
NPI:1629214713
Name:NIEMAN CORSO, SHARI LYNN (NP)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:LYNN
Last Name:NIEMAN CORSO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:LYNN
Other - Last Name:NIEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1000 SOUTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5654
Mailing Address - Country:US
Mailing Address - Phone:303-744-1065
Mailing Address - Fax:303-733-1699
Practice Address - Street 1:1000 SOUTHPARK DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5654
Practice Address - Country:US
Practice Address - Phone:303-744-1065
Practice Address - Fax:303-733-1699
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO105151363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO105151OtherCOLORADO LISCENSE