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General NPI Number Information
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NPI Number | 1407176480
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Entity Type | Individual
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Provider Name | SHANNON BETH GERBER RN, MSN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/01/2010
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 1918 CREST HAVEN CIR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-2901
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Country | US
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Telephone | 719-761-0397
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Fax |
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Provider Business Mailing Address
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Address Line | 4570 HAGERWOOD ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7535
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Country | US
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Telephone | 928-853-3123
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP3672
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 990039
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License Number State | CO
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