Healthcare Provider Details

I. General information

NPI: 1972005874
Provider Name (Legal Business Name): SHANNON ELIZABETH ZAFFINO CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANNON ELIZABETH WELDON NP

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 CONSTITUTION AVE NE BLDG D ENDOCRINOLOGY
ALBUQUERQUE NM
87110-7613
US

IV. Provider business mailing address

1502 NE MOON RIDGE RD
WASHOUGAL WA
98671-9560
US

V. Phone/Fax

Practice location:
  • Phone: 505-559-6400
  • Fax: 505-559-6488
Mailing address:
  • Phone: 832-314-0082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number8E886C5C
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP61052215
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number201807632NP-PP
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number67625
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: