Individual
TANYA LISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6900
Mailing address
PO BOX 1106, FRUITLAND, NM 87416-1106
(505) 330-1413
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
895
NM
Other
Enumeration date
04/18/2024
Last updated
04/07/2025
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