Healthcare Provider Details
I. General information
NPI: 1053536821
Provider Name (Legal Business Name): SHAWN EVETTE JOYNER NMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/16/2007
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1455 DIXON AVE STE 300
LAFAYETTE CO
80026-8880
US
IV. Provider business mailing address
1455 DIXON AVE STE 300
LAFAYETTE CO
80026-8880
US
V. Phone/Fax
- Phone: 303-443-8500
- Fax:
- Phone: 303-443-8500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | 04-793 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: