Provider Demographics
NPI:1295191823
Name:TANN, SHEILA SUSAN (ND, APRN, CPNP, PMHS)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:SUSAN
Last Name:TANN
Suffix:
Gender:F
Credentials:ND, APRN, CPNP, PMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 12TH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-1231
Mailing Address - Country:US
Mailing Address - Phone:720-432-0244
Mailing Address - Fax:949-561-5106
Practice Address - Street 1:700 12TH ST STE 220
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-1231
Practice Address - Country:US
Practice Address - Phone:720-432-0244
Practice Address - Fax:949-561-5106
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO09920812080P0006X
COAPN.0992081-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics