IndividualActive
Shannon Ballard, PA-C
NPI 1962723130 · Medical Physician Assistant · Newcastle, WY
Provider details
- NPI number
- 1962723130
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1124 Washington Blvd
Newcastle, WY 82701-2972
Phone: (307) 746-3700
Approximate (ZIP-level) locationGet directions
Mailing address
2801 Purcell St
Brighton, CO 80601-3551
Additional practice locations (1)
- 921 Ballancee AveLusk, WY 82225-5245Phone: (720) 316-6903
Registry dates
- Enumerated
- 2010-06-22
- Last updated
- 2025-12-31
- Certified
- 2025-12-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.