MEDICARE: SHANNON WRIGHT PMHNP-BC, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	780390	TX
2	363LF0000X	Family Nurse Practitioner	780390	TX
3	363L00000X	Nurse Practitioner	APN.0998448-NP	CO
4	363LF0000X	Family Nurse Practitioner	APN.0998448-NP	CO
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.0998448-NP	CO

General Provider Information

NPI Number	:	1215365994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON WRIGHT PMHNP-BC, FNP-C

Provider Business Mailing Address
First Line	:	1864 WOODMOOR DR STE 217
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-9095
Country	:	US
Telephone Number	:	719-631-1605
Fax Number	:	719-249-9587

Provider Business Practice Location Address
First Line	:	1864 WOODMOOR DR STE 217
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-9095
Country	:	US
Telephone Number	:	719-631-1605
Fax Number	:	719-249-9587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2013
Last Update Date	:	01/06/2026

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