Tisdall, Shayna M

Tisdall, Shayna M is an individual health care provider with primary practice located at 5200 Dtc Pkwy Suite 400, Greenwood Village CO 80111-2709. 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. Tisdall, Shayna M can be contacted via phone (303) 745-0000.

Contact Information

Primary practice address
5200 Dtc Pkwy Suite 400 Greenwood Village CO 80111-2709
Phone: (303) 745-0000
Fax: (303) 773-3101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA2350 Colorado

Profile Details

NPI number 1023223278
LBN Legal business name Tisdall, Shayna M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2007
Last updated Mar 7th, 2016 - about 9 years ago

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 1023223278 NPPES
Colorado MEDICAID 31187358
Colorado Other 019216

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