Provider Demographics
NPI:1891480638
Name:SHIELDS, SHELLEY MARIE (WHNP)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:MARIE
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 SAINT ANDREWS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-3274
Mailing Address - Country:US
Mailing Address - Phone:720-746-8823
Mailing Address - Fax:
Practice Address - Street 1:761 SAINT ANDREWS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-3274
Practice Address - Country:US
Practice Address - Phone:720-746-8823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995859-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health