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Individual

PATRICIA ANN SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
4351 E LOHMAN AVE STE 208, LAS CRUCES, NM 88011-8260
(575) 523-6554
(575) 523-5357
Mailing address
4351 E LOHMAN AVE STE 208, LAS CRUCES, NM 88011-8260
(575) 523-6554
(575) 523-5357

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
170523
CO
363L00000X
Nurse Practitioner
Primary
CNP-2403
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09685758
CO
Enumeration date
05/28/2009
Last updated
09/17/2020
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