Provider Demographics
NPI:1215072111
Name:MCGUCKIN, SHAWNA D (BA)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:D
Last Name:MCGUCKIN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MS
Other - First Name:SHAWNA
Other - Middle Name:J
Other - Last Name:DILLNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:6387 S FAIRFAX WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-3521
Mailing Address - Country:US
Mailing Address - Phone:303-953-9355
Mailing Address - Fax:
Practice Address - Street 1:4141 E DICKENSON PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6012
Practice Address - Country:US
Practice Address - Phone:303-504-6667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study