Shastidy Pauline Lopez, CCSS
Shastidy Pauline Lopez, CCSS is a Military Health Care Provider in Tijeras, New Mexico. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
1 Camino Oro CtTijeras, NM 87059-7924
Phone: (706) 593-8731
Fax: (706) 593-8732
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Military Health Care Provider (primary) | Taxonomy 171000000X |
|---|
Record details
| NPI number | 1962273854 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | CCSS |
| Sole proprietor | No |
| NPI enumerated | January 10, 2024 |
| Last updated in NPPES | September 26, 2024 |
| Certification date | September 26, 2024 |