DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. CORISSA SUE SPACKMAN, CNS, LDN, NBC-HWC

Active Sole Proprietor

Nutritionist · SHERIDAN, WY

Registration Details

NPI Number
1326810417
Provider Type
Individual
Gender
Female
NPI Issued
Oct 23, 2023 (2.534338896806 yrs)
Last Updated
Nov 1, 2024
License
DX6913 (MD)
Sole Proprietor
Yes

Practice Information

Address
32 N GOULD ST STE R
SHERIDAN, WY, 828016317
Browse WY providers · Browse ZIP 82801
Phone
3073433680
Primary Specialty
Nutritionist
133N00000X
Additional Specialty
Nutrition, Education
Additional Specialty
Nutritionist
Additional Specialty
Health & Wellness Coach
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.