Basic Information
| Provider Information | |||||||||
| NPI: | 1104372564 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANDFORD | ||||||||
| FirstName: | SHAUNA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9732 S CARR WAY | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801278589 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036675019 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7720 S BROADWAY STE 440 | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801222624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037950890 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2016 | ||||||||
| LastUpdateDate: | 02/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN.0205262 | CO | N | Nursing Service Providers | Registered Nurse | 363LW0102X | APN.099058-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.