Individual
SHANNON L RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
1955 N VALLEY DR, LAS CRUCES, NM 88007-5154
(575) 523-2772
(575) 524-2993
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
62295
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22732811
—
NM
Enumeration date
02/02/2011
Last updated
01/30/2024
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