Individual
MRS. LISSA SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, MSN, R
Contact information
Practice address
4200 BECKNER RD, SANTA FE, NM 87507-3774
(505) 477-2200
Mailing address
2085 S PACHECO ST, SANTA FE, NM 87505-6103
(505) 477-2200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
74136
NM
Other
Enumeration date
07/03/2023
Last updated
05/28/2025
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