Healthcare Provider Details

I. General information

NPI: 1508295809
Provider Name (Legal Business Name): MEGHANN KELSEY SHEFFIELD P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 GARDEN OF THE GODS RD STE 120
COLORADO SPRINGS CO
80907-9427
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-329-1000
  • Fax: 719-598-0807
Mailing address:
  • Phone: 970-624-4034
  • Fax: 970-490-4347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number51296
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4031
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: