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Individual

SHANNON BETH GERBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, NP-C

Contact information

Practice address
1918 CREST HAVEN CIR, COLORADO SPRINGS, CO 80909-2901
(719) 761-0397
Mailing address
4570 HAGERWOOD ST, COLORADO SPRINGS, CO 80920-7535
(928) 853-3123

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
990039
CO
363LA2200X
Adult Health Nurse Practitioner
AP3672
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04927273
CO
Enumeration date
06/01/2010
Last updated
05/31/2013
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