Provider Demographics
NPI:1295015261
Name:SHEHAN, ROSE (RN, CDE)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:SHEHAN
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 LUTHERAN PKWY
Mailing Address - Street 2:180
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6021
Mailing Address - Country:US
Mailing Address - Phone:303-403-7933
Mailing Address - Fax:303-403-7934
Practice Address - Street 1:3555 LUTHERAN PKWY
Practice Address - Street 2:180
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6021
Practice Address - Country:US
Practice Address - Phone:303-403-7933
Practice Address - Fax:303-403-7934
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO69435163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator