Provider Demographics
NPI:1508050253
Name:PAUL, SHELBIE R (NP)
Entity Type:Individual
Prefix:
First Name:SHELBIE
Middle Name:R
Last Name:PAUL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHELBIE
Other - Middle Name:R
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-788-8808
Mailing Address - Fax:303-788-6656
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2736
Practice Address - Country:US
Practice Address - Phone:303-788-8808
Practice Address - Fax:303-788-6656
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4945363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO42072026Medicaid
CO810203Medicare PIN
COCO306636Medicare PIN
CO42072026Medicaid