Provider Demographics
NPI:1831161983
Name:ALLEN, SHARON A (WHNP-BC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:A
Last Name:ALLEN
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 S CASCADE AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1604
Mailing Address - Country:US
Mailing Address - Phone:719-866-6568
Mailing Address - Fax:719-538-2999
Practice Address - Street 1:320 E. FONTANERO STREET, SUITE 100
Practice Address - Street 2:COLORADO SPRINGS VA CLINIC - FONTANERO ANNEX
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-327-5660
Practice Address - Fax:719-866-6239
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0005766-NP363L00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41176500Medicaid
Q00183Medicare UPIN
WI41176500Medicaid