Individual
MS. SHELLY THIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16222 W US HIGHWAY 24, WOODLAND PARK, CO 80863-8762
(719) 687-6022
(719) 687-6030
Mailing address
16222 W US HIGHWAY 24, WOODLAND PARK, CO 80863-8762
(719) 687-6022
(719) 687-6030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1697
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40325750
—
CO
Enumeration date
05/05/2006
Last updated
10/15/2008
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