Healthcare Provider Details

I. General information

NPI: 1174966121
Provider Name (Legal Business Name): SHANNON ROSE BARKER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 S COLLEGE AVE
FORT COLLINS CO
80525-1721
US

IV. Provider business mailing address

4503 JOHN F KENNEDY PKWY
FORT COLLINS CO
80525-3250
US

V. Phone/Fax

Practice location:
  • Phone: 970-484-1410
  • Fax: 970-484-3083
Mailing address:
  • Phone: 970-223-5769
  • Fax: 970-223-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number13574
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: