Individual
SHANNON RYAN-CEBULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8383 W ALAMEDA AVE, LAKEWOOD, CO 80226-3007
(303) 338-4545
Mailing address
10900 W 44TH AVE UNIT 200, WHEAT RIDGE, CO 80033-2742
(720) 923-1250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47532
CO
390200000X
Student in an Organized Health Care Education/Training Program
TL2435
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020783
KAISER COMMERCIAL NUMBER
CO
05
—
26905566
—
CO
Enumeration date
07/15/2008
Last updated
03/23/2023
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