Corissa Sue Spackman, CNS, LDN, NBC-HWC
NPI 1326810417ActiveIndividual· Nutritionist· Sheridan, WY
Nutritionist (CNS, LDN, NBC-HWC) in Sheridan, Wyoming, licensed in MD, with an NPI issued in October 2023.
Overview
| NPI | 1326810417 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CNS, LDN, NBC-HWC |
| Sole proprietor | Yes |
| NPI issued | Oct 23, 2023 |
| Last updated in NPPES | Nov 1, 2024 |
| Certified by provider | Nov 1, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nutritionist Primary | 133N00000X | DX6913 | MD |
| Nutritionist, Nutrition, Education | 133NN1002X | — | — |
| Nutritionist | 133N00000X | — | — |
| Health & Wellness Coach | 171400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Nutritionist providers in Sheridan
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