Individual
SHAWNA PATRICE MARION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4100 HIGH RESORT BLVD SE, RIO RANCHO, NM 87124-5901
(505) 291-2222
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0000151934
TN
363L00000X
Nurse Practitioner
Primary
56878
NM
363LF0000X
Family Nurse Practitioner
12390
TN
363LF0000X
Family Nurse Practitioner
APN56978
NM
Other
Enumeration date
12/08/2006
Last updated
07/25/2023
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