Healthcare Provider Details

I. General information

NPI: 1093127458
Provider Name (Legal Business Name): SHANNON ELIZABETH BARKER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNON E EDWARDS DO

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10180 W HAPPY VALLEY PKWY STE 100
PEORIA AZ
85383-1389
US

IV. Provider business mailing address

10180 W HAPPY VALLEY PKWY STE 100
PEORIA AZ
85383-1389
US

V. Phone/Fax

Practice location:
  • Phone: 623-322-3380
  • Fax: 623-234-3274
Mailing address:
  • Phone: 623-322-3380
  • Fax: 623-234-3274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number009471
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: