Healthcare Provider Details

I. General information

NPI: 1538073671
Provider Name (Legal Business Name): SHANNON BECKER RN, BSN, CPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13123 E 16TH AVE # 245
AURORA CO
80045-7106
US

IV. Provider business mailing address

13123 E 16TH AVE # 245
AURORA CO
80045-7106
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-6457
  • Fax:
Mailing address:
  • Phone: 720-777-6457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1647060
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: