Individual
MRS. SHANNON VANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, FNP-C, CPN
Contact information
Practice address
190 HOWARD PL STE A, LAS CRUCES, NM 88011-8155
(575) 288-3216
Mailing address
PO BOX 1071, ALAMOGORDO, NM 88311-1071
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
57868
NM
Other
Enumeration date
12/13/2019
Last updated
12/13/2019
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