Individual
MS. SHANNON ELIZABETH SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
413 SIPAPU ROAD, # 6952, TAOS, NM 87571
(575) 758-5857
(575) 758-5857
Mailing address
650 GUARA LANE, TAOS, NM 87571
(575) 758-2494
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L20200
NM
Other
Enumeration date
10/15/2009
Last updated
10/15/2009
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