Provider Demographics
NPI:1427810886
Name:SHELLY, RACHAEL M (NP)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:M
Last Name:SHELLY
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:5445 DTC PKWY STE 1130
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3038
Mailing Address - Country:US
Mailing Address - Phone:720-749-5599
Mailing Address - Fax:720-925-5897
Practice Address - Street 1:3204 N ACADEMY BLVD STE 300
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5164
Practice Address - Country:US
Practice Address - Phone:719-323-6224
Practice Address - Fax:720-925-5897
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-04-15
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Provider Licenses
StateLicense IDTaxonomies
COAPN.0999179-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily