=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639802143
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHANNON B LANSFORD DNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/03/2022
-----------------------------------------------------
Last Update Date | 12/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1923 W COLORADO AVE
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80904-3838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-600-8563
-----------------------------------------------------
Fax | 877-805-7372
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8275 DIORITE DR
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80938-9609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-990-5604
-----------------------------------------------------
Fax | 877-805-7372
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APN.1000223-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN.1653994
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------