Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 5987 | CO |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 5988 | CO |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 5987 | CO |
NPI | 1023240645 |
---|---|
Provider Name | Ms. Lynn Marie Shields |
First Address | Denver, CO 80256-0825 |
Second Address | Colorado City, CO 81019-9990 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2009 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06358306 | (05) | CO |