Healthcare Provider Details

I. General information

NPI: 1508212986
Provider Name (Legal Business Name): SHAUNA MCWILLIAMS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 06/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 S BROADWAY SUITE 590
LITTLETON CO
80122-2632
US

IV. Provider business mailing address

26659 PLEASANT PARK RD
CONIFER CO
80433-7714
US

V. Phone/Fax

Practice location:
  • Phone: 303-703-8583
  • Fax: 303-703-9791
Mailing address:
  • Phone: 303-647-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0991968-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: