Provider Demographics
NPI:1528432390
Name:SHIN, SHARON (CNM)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SHIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13120 E 19TH AVE # C288-5
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2567
Mailing Address - Country:US
Mailing Address - Phone:303-724-1362
Mailing Address - Fax:
Practice Address - Street 1:1925 MOUNTAIN VIEW AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3128
Practice Address - Country:US
Practice Address - Phone:720-494-3128
Practice Address - Fax:720-985-7349
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993554-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife