Individual
DANA SHOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PUEBLO OF SAN FELIPE, SAN FELIPE PUEBLO, SAN FELIPE PUEBLO, NM 87001
(505) 771-9915
Mailing address
PO BOX 4339, PUEBLO OF SAN FELIPE, SAN FELIPE PUEBLO, NM 87001
(505) 771-9915
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R49626
NM
163WC1500X
Community Health Registered Nurse
R49626
NM
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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