Shively, Sara Elizabeth

Shively, Sara Elizabeth is an individual health care provider with primary practice located at 52 Village Dr , Pagosa Springs CO 81147-8368. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Shively, Sara Elizabeth can be contacted via phone (970) 264-2104.

Contact Information

Primary practice address
52 Village Dr Pagosa Springs CO 81147-8368
Phone: (970) 264-2104
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA.0003685 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA2015-0097 New Mexico

Profile Details

NPI number 1275768673
LBN Legal business name Shively, Sara Elizabeth
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2009
Last updated May 28th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275768673 NPPES
New Mexico MEDICAID 16531779

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