Healthcare Provider Details

I. General information

NPI: 1285128413
Provider Name (Legal Business Name): CHEYENNE SHIPMAN PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHEYENNE KUHN

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 E 3RD ST
LA JUNTA CO
81050
US

IV. Provider business mailing address

1206 E 3RD ST
LA JUNTA CO
81050-1907
US

V. Phone/Fax

Practice location:
  • Phone: 719-413-5261
  • Fax:
Mailing address:
  • Phone: 719-413-5261
  • Fax: 719-888-1767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0998137-NP
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: