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Contact Information

CORISSA S SPACKMAN, CNS, LDN, NBC-HWC
32 N GOULD ST STE R
SHERIDAN, WY82801-6317
 Phone: 307-343-3680
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutritionist

133N00000X
 

Health & Wellness Coach

171400000X
 

Nutrition, Education

133NN1002X
Indicates primary specialty

NPI Profile & details for CORISSA S SPACKMAN · (Female)

NPI Number 1326810417
Status Active
Credentials CNS, LDN, NBC-HWC
Entity Individual
Enumeration date 10/23/2023
Last updated 11/01/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • MD License # DX6913
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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