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Individual

MARIAH SHATTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4420 IRVING BLVD NW, ALBUQUERQUE, NM 87114-5915
(505) 727-6300
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
65401
NM
363L00000X
Nurse Practitioner
Primary
57662
NM
363LF0000X
Family Nurse Practitioner
57662
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
57662
NM LICENSE
NM
Enumeration date
11/05/2021
Last updated
06/30/2025
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