Healthcare Provider Details

I. General information

NPI: 1437060647
Provider Name (Legal Business Name): SOO HYUN SHIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2822 E COLFAX AVE
DENVER CO
80206-1507
US

IV. Provider business mailing address

2590 WELTON ST APT 721
DENVER CO
80205-3784
US

V. Phone/Fax

Practice location:
  • Phone: 303-953-2299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1710563
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: