Healthcare Provider Details

I. General information

NPI: 1861624066
Provider Name (Legal Business Name): SHIRLEY GARCIA CHERINO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 ALAMO AVE SE
ALBUQUERQUE NM
87106-3204
US

IV. Provider business mailing address

3406 MOUNTAINSIDE PKWY NE
ALBUQUERQUE NM
87111-5192
US

V. Phone/Fax

Practice location:
  • Phone: 505-925-2494
  • Fax: 505-925-2491
Mailing address:
  • Phone: 505-925-2494
  • Fax: 505-925-2491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberR26798
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: