Healthcare Provider Details

I. General information

NPI: 1558576512
Provider Name (Legal Business Name): SHAWN RENEE BREKKE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2007
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 E HAMPDEN AVE STE 405
DENVER CO
80231
US

IV. Provider business mailing address

7535 E HAMPDEN AVE STE 405
DENVER CO
80231-4844
US

V. Phone/Fax

Practice location:
  • Phone: 303-768-5060
  • Fax: 303-996-2660
Mailing address:
  • Phone: 303-768-5060
  • Fax: 303-996-2660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number993692
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: