Provider Demographics
NPI:1902826985
Name:MARTIN, SHARON MILLER (ARNP CNM)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MILLER
Last Name:MARTIN
Suffix:
Gender:F
Credentials:ARNP CNM
Other - Prefix:MS
Other - First Name:SHANA
Other - Middle Name:MILLER
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP CNM
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-788-8808
Mailing Address - Fax:303-788-6656
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:#110
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2736
Practice Address - Country:US
Practice Address - Phone:303-788-8808
Practice Address - Fax:303-788-6656
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO91210367A00000X
FL1858792367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47708531Medicaid
FL033631901Medicaid
CO406016YTUOMedicare PIN