Healthcare Provider Details

I. General information

NPI: 1932715844
Provider Name (Legal Business Name): SHAWNNA JESSICA KIRBY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 E 12TH AVE
DENVER CO
80220-2415
US

IV. Provider business mailing address

1290 CHAMBERS RD
AURORA CO
80011-7117
US

V. Phone/Fax

Practice location:
  • Phone: 303-504-7782
  • Fax:
Mailing address:
  • Phone: 303-617-2300
  • Fax: 303-617-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.1704641
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN.0331564
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: