Provider Demographics
NPI:1801884804
Name:SHVIRAGA, BONITA A (MS-CNM)
Entity type:Individual
Prefix:MRS
First Name:BONITA
Middle Name:A
Last Name:SHVIRAGA
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Gender:F
Credentials:MS-CNM
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Mailing Address - Street 1:4900 S MONACO ST STE 210
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3487
Mailing Address - Country:US
Mailing Address - Phone:303-873-5245
Mailing Address - Fax:303-873-5240
Practice Address - Street 1:1400 S POTOMAC ST
Practice Address - Street 2:#225
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4514
Practice Address - Country:US
Practice Address - Phone:303-873-5245
Practice Address - Fax:303-873-5240
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2016-06-22
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Provider Licenses
StateLicense IDTaxonomies
CO1655367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07896665Medicaid
COCO306940Medicare PIN
CO07896665Medicaid
CO455328Medicare PIN