Individual
SHALA MARIE CAUDILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2421 W 21ST ST STE B, CLOVIS, NM 88101-2006
(620) 259-0903
Mailing address
2421 W 21ST ST STE B, CLOVIS, NM 88101-2006
(620) 259-0903
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2026011637
MO
363L00000X
Nurse Practitioner
78291
NM
363LF0000X
Family Nurse Practitioner
Primary
78291
NM
Other
Enumeration date
03/29/2024
Last updated
04/10/2026
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