Provider Demographics
NPI:1104610757
Name:NOON, SHANA (APRN, CNM, IBCLC)
Entity type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:NOON
Suffix:
Gender:
Credentials:APRN, CNM, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6690 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-2308
Mailing Address - Country:US
Mailing Address - Phone:570-778-6174
Mailing Address - Fax:
Practice Address - Street 1:9475 BRIAR VILLAGE PT STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7902
Practice Address - Country:US
Practice Address - Phone:719-367-9405
Practice Address - Fax:719-434-9777
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0999549-CNM176B00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife