Healthcare Provider Details

I. General information

NPI: 1528989043
Provider Name (Legal Business Name): KIRSTEN LEIGH SHELTON PTA.0015856
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 DELMONICO DR STE 100
COLORADO SPRINGS CO
80919-2243
US

IV. Provider business mailing address

706 RALSTON CT APT B
COLORADO SPRINGS CO
80909-8820
US

V. Phone/Fax

Practice location:
  • Phone: 719-257-4240
  • Fax:
Mailing address:
  • Phone: 773-865-2363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0015856
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: