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General NPI Number Information
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NPI Number | 1629846886
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Entity Type | Individual
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Provider Name | SHIAN N HANKS LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 175 INVERNESS DR W STE 200
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City | ENGLEWOOD
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State | CO
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Zip | 80112-5069
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Country | US
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Telephone | 303-694-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 175 INVERNESS DR W STE 200
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City | ENGLEWOOD
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State | CO
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Zip | 80112-5069
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Country | US
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Telephone | 719-377-0068
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | SA.0003256
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | ATR-LAT-LIC-2548
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License Number State | MT
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