Provider Demographics
NPI:1609623859
Name:SHARP, NICOLE (IHP, LMT, CMLDT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:IHP, LMT, CMLDT
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:LUNSFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IHP, LMT, CMLDT
Mailing Address - Street 1:150 E 29TH ST STE 285
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2770
Mailing Address - Country:US
Mailing Address - Phone:970-444-2364
Mailing Address - Fax:
Practice Address - Street 1:150 E 29TH ST STE 285
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2770
Practice Address - Country:US
Practice Address - Phone:970-444-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO173C00000X
COMT.0025781225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist