Provider Demographics
NPI:1831392943
Name:DAHLIN-LOPEZ, SHAREEN AMINA (RN, CCM)
Entity type:Individual
Prefix:MS
First Name:SHAREEN
Middle Name:AMINA
Last Name:DAHLIN-LOPEZ
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9787 HURTY AVE
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9113
Mailing Address - Country:US
Mailing Address - Phone:303-838-9731
Mailing Address - Fax:303-838-9731
Practice Address - Street 1:9787 HURTY AVE
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-9113
Practice Address - Country:US
Practice Address - Phone:303-838-9731
Practice Address - Fax:303-838-9731
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO90155163WC0400X, 163WH0200X, 163WM1400X, 163WW0000X, 171M00000X, 3747A0650X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374U00000XNursing Service Related ProvidersHome Health Aide