Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shannon Stuyvesant, PTA

Individual provider Physical Therapist · NPI 1104215961

Shannon Stuyvesant, PTA is a Physical Therapist in Albuquerque, New Mexico. Practices as a sole proprietor. Licensed in New Mexico.

Licensed in
NM
In the registry since
2015
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

5123 Juan Tabo Blvd NE
Albuquerque, NM 87111-2672
Phone: (505) 292-3333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence A-62 (NM)

Record details

NPI number1104215961
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedJanuary 16, 2015
Last updated in NPPESJanuary 16, 2015

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