Individual provider · Type 1 NPI

Colton Shaner

Student in an Organized Health Care Education/Training Program · Jbsa Lackland, TX

NPI number 1164285706 Active

Practice location

2133 Pepperrell St Bldg 3352
Jbsa Lackland, TX 78236-5313

Call (210) 292-7269 Map

Mailing address

1001 Shadow Ln
Las Vegas, NV 89106-4124

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1164285706

Colton Shaner's National Provider Identifier is 1164285706, issued on Feb 6, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Jbsa Lackland, TX. The record was last updated on Jul 13, 2026.