Individual
SHANNON KHATTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10375 PARK MEADOWS DR STE 270, LONE TREE, CO 80124-6760
(720) 749-5599
(720) 925-5897
Mailing address
5445 DTC PKWY STE 1130, GREENWOOD VILLAGE, CO 80111-3038
(720) 749-5599
(720) 925-5897
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0007435
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2021
Last updated
03/12/2024
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