Healthcare Provider Details

I. General information

NPI: 1417754391
Provider Name (Legal Business Name): SHAWN'S ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 PALOMAS DR SE
ALBUQUERQUE NM
87108-3634
US

IV. Provider business mailing address

809 PALOMAS DR SE
ALBUQUERQUE NM
87108-3634
US

V. Phone/Fax

Practice location:
  • Phone: 505-440-6518
  • Fax:
Mailing address:
  • Phone: 505-440-6518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAWN M MCGEE
Title or Position: OWNER
Credential: FNP, PMHNP
Phone: 505-440-6518