Provider Demographics
NPI:1922271667
Name:JESUS, SHAWNDEY MARIE (MA)
Entity Type:Individual
Prefix:
First Name:SHAWNDEY
Middle Name:MARIE
Last Name:JESUS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1354 S FULTON WAY
Mailing Address - Street 2:F103
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-7409
Mailing Address - Country:US
Mailing Address - Phone:303-755-2169
Mailing Address - Fax:
Practice Address - Street 1:2045 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5437
Practice Address - Country:US
Practice Address - Phone:303-761-4949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist