Healthcare Provider Details

I. General information

NPI: 1831161983
Provider Name (Legal Business Name): SHARON A ALLEN WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E. FONTANERO STREET, SUITE 100 COLORADO SPRINGS VA CLINIC - FONTANERO ANNEX
COLORADO SPRINGS CO
80920
US

IV. Provider business mailing address

2 S CASCADE AVE STE 140
COLORADO SPRINGS CO
80903-1604
US

V. Phone/Fax

Practice location:
  • Phone: 719-327-5660
  • Fax: 719-866-6239
Mailing address:
  • Phone: 719-866-6568
  • Fax: 719-538-2999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0005766-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPN.0005766-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: