Healthcare Provider Details

I. General information

NPI: 1407771363
Provider Name (Legal Business Name): SHELBY PONS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHELBY EVANS

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12605 E 16TH AVE
AURORA CO
80045-2520
US

IV. Provider business mailing address

791 NEWPORT ST
DENVER CO
80220-5554
US

V. Phone/Fax

Practice location:
  • Phone: 757-513-0113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberPHA.0021006
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: