Healthcare Provider Details

I. General information

NPI: 1316510886
Provider Name (Legal Business Name): SHAYLEE A ABEYTA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 EUBANK BLVD NE STE A
ALBUQUERQUE NM
87111-3590
US

IV. Provider business mailing address

9428 TASCO DR NE
ALBUQUERQUE NM
87111-2222
US

V. Phone/Fax

Practice location:
  • Phone: 505-292-8575
  • Fax:
Mailing address:
  • Phone: 505-903-4116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number64571
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: