Individual
SHANNON L. RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2222 N NEVADA AVE, STE 4007, COLORADO SPRINGS, CO 80907-6819
(719) 776-8600
(719) 634-1448
Mailing address
2695 ROCKY MOUNTAIN AVE, STE 150, LOVELAND, CO 80538-9071
(970) 624-4451
(970) 490-4199
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-2330
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA-2330
LICENSE
CO
Enumeration date
10/13/2006
Last updated
12/22/2017
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