Individual
SHONA STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
300 GRIFFIN ST, SANTA FE, NM 87501-1823
(505) 467-4705
Mailing address
300 GRIFFIN ST, SANTA FE, NM 87501-1823
(505) 467-4705
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R67704
NM
Other
Enumeration date
03/10/2023
Last updated
03/10/2023
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