Healthcare Provider Details

I. General information

NPI: 1295641397
Provider Name (Legal Business Name): STACEY LEIGH SCHNEIDER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 CENTRE AVE SE
ALBUQUERQUE NM
87106-4180
US

IV. Provider business mailing address

246 DINKLE RD
EDGEWOOD NM
87015-9552
US

V. Phone/Fax

Practice location:
  • Phone: 505-248-3200
  • Fax: 505-248-3203
Mailing address:
  • Phone: 505-265-1711
  • Fax: 505-248-3203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR35870
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: