Healthcare Provider Details

I. General information

NPI: 1558908491
Provider Name (Legal Business Name): SHEILA ROSE BEADES ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 02/20/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5883 MANHATTAN CIRCLE SUITE B
BOULDER CO
80303
US

IV. Provider business mailing address

5883 MANHATTAN CIRCLE SUITE B
BOULDER CO
80303
US

V. Phone/Fax

Practice location:
  • Phone: 303-884-7557
  • Fax:
Mailing address:
  • Phone: 303-884-7557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number0000184
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: