Provider Demographics
NPI:1801159868
Name:KIKER, SHAWNA MICHELLE (ND)
Entity type:Individual
Prefix:DR
First Name:SHAWNA
Middle Name:MICHELLE
Last Name:KIKER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 BERGEN PKWY UNIT C
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9541
Mailing Address - Country:US
Mailing Address - Phone:303-679-3402
Mailing Address - Fax:303-679-1921
Practice Address - Street 1:1301 BERGEN PKWY UNIT C
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9541
Practice Address - Country:US
Practice Address - Phone:303-679-3402
Practice Address - Fax:303-679-1921
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-24
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60256022175F00000X
COND.0000074175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath