Healthcare Provider Details

I. General information

NPI: 1245827674
Provider Name (Legal Business Name): SHANNON FIELDING RN-MSN, FNP-C, CPE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2020
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 N LOGAN ST STE 407
DENVER CO
80203-3155
US

IV. Provider business mailing address

899 N LOGAN ST STE 407
DENVER CO
80203-3155
US

V. Phone/Fax

Practice location:
  • Phone: 615-485-5293
  • Fax: 888-710-3082
Mailing address:
  • Phone: 615-485-5293
  • Fax: 888-710-3082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1630524
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number07-07024
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0022025
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN.1000756-NP
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1000756-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: