Individual
MARILYN D MILLER-SHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1960 N DATE ST, T OR C, NM 87901-3701
(575) 894-7662
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 266-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP00485
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R25875
APN STATE LICENSURE
NM
Enumeration date
01/24/2006
Last updated
01/11/2022
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