Individual
CARISSA SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2222 N NEVADA AVE, COLORADO SPRINGS, CO 80907-6819
(719) 776-5000
Mailing address
2222 N NEVADA AVE STE 1, COLORADO SPRINGS, CO 80907-6794
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RXN.0104425-NP
CO
363LG0600X
Gerontology Nurse Practitioner
RXN.0104425-NP
CO
Other
Enumeration date
12/21/2019
Last updated
12/21/2019
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