MEDICARE: MS. SHIRLEY ANN SAWYER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	67953	CO
2	363L00000X	Nurse Practitioner	APN.0003748-NP	CO

General Provider Information

NPI Number	:	1295787208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHIRLEY ANN SAWYER NP

Provider Business Mailing Address
First Line	:	1335 PHAY AVE
Second Line	:	STE D
City	:	CANON CITY
State	:	CO
Zip	:	81212
Country	:	US
Telephone Number	:	719-269-8820
Fax Number	:	719-204-0230

Provider Business Practice Location Address
First Line	:	3245 E US HIGHWAY 50 UNIT E
Second Line	:
City	:	CANON CITY
State	:	CO
Zip	:	81212-9343
Country	:	US
Telephone Number	:	719-285-2888
Fax Number	:	719-285-2889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/21/2022

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