Individual
SARA ELIZABETH SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
52 VILLAGE DR, PAGOSA SPRINGS, CO 81147-8368
(970) 264-2104
Mailing address
PO BOX 1328, DURANGO, CO 81302-1328
(970) 335-2342
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0003685
CO
363A00000X
Physician Assistant
PA2015-0097
NM
363A00000X
Physician Assistant
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16531779
—
NM
Enumeration date
05/29/2009
Last updated
02/11/2026
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