Individual
DR. TRACI SHAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
600 S AIRPORT RD BLDG A, LONGMONT, CO 80503-6424
(720) 378-6900
(877) 241-8199
Mailing address
600 S AIRPORT RD BLDG A, LONGMONT, CO 80503-6424
(720) 378-6900
(877) 241-8199
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
3082
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112531
NURSING LICENSE
CO
Enumeration date
12/21/2007
Last updated
10/25/2017
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