Healthcare Provider Details

I. General information

NPI: 1639790587
Provider Name (Legal Business Name): SHAWNNA DURAND SNODGRASS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 CARPENTER RD
FORT COLLINS CO
80525-4248
US

IV. Provider business mailing address

3579 CRESTONE DR
LOVELAND CO
80537-3500
US

V. Phone/Fax

Practice location:
  • Phone: 970-663-3500
  • Fax:
Mailing address:
  • Phone: 970-310-4128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN0994617-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: