Individual
TARA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2920 N CASCADE AVE, COLORADO SPRINGS, CO 80907-6262
(719) 636-1201
Mailing address
2920 N CASCADE AVE STE 301, COLORADO SPRINGS, CO 80907-6265
(719) 636-1201
(719) 636-1326
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN.0993990-NP
CO
Other
Enumeration date
08/31/2018
Last updated
10/11/2019
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