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General NPI Number Information
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NPI Number | 1740908961
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Entity Type | Individual
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Provider Name | SHANNON STEWART DNP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 1090 S. WADSWORTH BLVD. UNIT C #3108
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City | LAKEWOOD
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State | CO
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Zip | 80226-4350
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Country | US
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Telephone | 720-797-5186
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Fax | 720-405-4313
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Provider Business Mailing Address
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Address Line | 1090 S. WADSWORTH BLVD. UNIT C #3108
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City | LAKEWOOD
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State | CO
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Zip | 80226-4350
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Country | US
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Telephone | 720-797-5186
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Fax | 720-405-4313
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 00004437
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-APN.0004437-C-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-APN.0004437
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License Number State | CO
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