Healthcare Provider Details

I. General information

NPI: 1750055547
Provider Name (Legal Business Name): SHANNON STARKEY DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8210 LA MIRADA PL NE STE 700
ALBUQUERQUE NM
87109-1620
US

IV. Provider business mailing address

8210 LA MIRADA PL NE STE 700
ALBUQUERQUE NM
87109-1620
US

V. Phone/Fax

Practice location:
  • Phone: 505-807-3086
  • Fax: 505-807-3086
Mailing address:
  • Phone: 505-807-3086
  • Fax: 505-807-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number64592
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: