Provider Demographics
NPI:1588134118
Name:NIEUSMA, ALEESHA BETH (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEESHA
Middle Name:BETH
Last Name:NIEUSMA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 SAPPHIRE WAY
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027
Mailing Address - Country:US
Mailing Address - Phone:303-877-2391
Mailing Address - Fax:
Practice Address - Street 1:470 GRANT RD
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802
Practice Address - Country:US
Practice Address - Phone:509-886-7047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14092183500000X
WA60874893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist