Healthcare Provider Details

I. General information

NPI: 1649735663
Provider Name (Legal Business Name): SHAYLA FEKETY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9524 FEDERAL DR STE 120
COLORADO SPRINGS CO
80921-4342
US

IV. Provider business mailing address

9524 FEDERAL DR STE 120
COLORADO SPRINGS CO
80921-4342
US

V. Phone/Fax

Practice location:
  • Phone: 719-394-3352
  • Fax:
Mailing address:
  • Phone: 719-394-3352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.1634215
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.1002227-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: