Individual
TY SHETTRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1144 LAKE GULCH RD, CASTLE ROCK, CO 80104-9743
(303) 328-1838
Mailing address
1144 LAKE GULCH RD, CASTLE ROCK, CO 80104-9743
(303) 328-1838
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024193274
VA
363LF0000X
Family Nurse Practitioner
Primary
0990954
CO
363LF0000X
Family Nurse Practitioner
70369
NM
363LF0000X
Family Nurse Practitioner
GAA-NP001776
GA
363LF0000X
Family Nurse Practitioner
SP032245
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89279077
—
CO
Enumeration date
11/01/2013
Last updated
12/29/2025
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