Provider Demographics
NPI:1811887193
Name:CODNER, SHARON MICHELLE
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:MICHELLE
Last Name:CODNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9471 W WOOD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WOOD RIVER
Mailing Address - State:NE
Mailing Address - Zip Code:68883-9420
Mailing Address - Country:US
Mailing Address - Phone:308-383-5395
Mailing Address - Fax:
Practice Address - Street 1:13800 W WOOD RIVER RD
Practice Address - Street 2:
Practice Address - City:WOOD RIVER
Practice Address - State:NE
Practice Address - Zip Code:68883-9456
Practice Address - Country:US
Practice Address - Phone:308-583-2249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant