Individual
KRYSTAL MARIE SHOTLIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
201 LAMKIN ST. UNIT 101, PUEBLO, CO 81003-8100
(719) 543-6633
(719) 543-6655
Mailing address
401 N 3RD ST, CANON CITY, CO 81212-3270
(719) 792-9192
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0998109
CO
363LF0000X
Family Nurse Practitioner
Primary
0998109
CO
Other
Enumeration date
10/19/2022
Last updated
01/23/2023
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