Healthcare Provider Details

I. General information

NPI: 1104610757
Provider Name (Legal Business Name): SHANA NOON APRN, CNM, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9475 BRIAR VILLAGE PT STE 100
COLORADO SPRINGS CO
80920-7902
US

IV. Provider business mailing address

6690 ALBION ST
COMMERCE CITY CO
80022-2308
US

V. Phone/Fax

Practice location:
  • Phone: 719-367-9405
  • Fax: 719-434-9777
Mailing address:
  • Phone: 570-778-6174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberAPN.0999549-CNM
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: