Individual
SHELLEY ANNE O'NEIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 S POTOMAC ST, AURORA, CO 80012-5411
(303) 695-2628
(303) 306-7753
Mailing address
PO BOX 173862, DENVER, CO 80217-3862
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004877
GA
363A00000X
Physician Assistant
50001556
OH
363A00000X
Physician Assistant
Primary
PA.0002564
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77254848
—
CO
01
—
P00950672
RAILROAD MEDICARE
CO
Enumeration date
01/05/2006
Last updated
06/25/2015
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