Healthcare Provider Details

I. General information

NPI: 1811498140
Provider Name (Legal Business Name): SHELLY R HAMBEK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11483 HOT SPRINGS DR
PARKER CO
80138-8029
US

IV. Provider business mailing address

11483 HOT SPRINGS DR
PARKER CO
80138-8029
US

V. Phone/Fax

Practice location:
  • Phone: 720-203-2926
  • Fax:
Mailing address:
  • Phone: 720-203-2926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0130989
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: