Healthcare Provider Details

I. General information

NPI: 1780360065
Provider Name (Legal Business Name): SHANNA HAYDU BOWMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNA BETH HAYDU NP

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 W CANAL CT ST 20
LITTLETON CO
80120-5660
US

IV. Provider business mailing address

9071 E MISSISSIPPI AVE APT 32E
DENVER CO
80247-2062
US

V. Phone/Fax

Practice location:
  • Phone: 720-466-1932
  • Fax: 720-802-7462
Mailing address:
  • Phone: 860-488-0788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0998803-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: