Healthcare Provider Details

I. General information

NPI: 1255253464
Provider Name (Legal Business Name): SHELLY R NOE, DNP, PMHNP-BC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 N MAIN ST STE 11
LAS CRUCES NM
88001-1136
US

IV. Provider business mailing address

2211 N MAIN ST STE 11 SUITE 11
LAS CRUCES NM
88001-1136
US

V. Phone/Fax

Practice location:
  • Phone: 575-449-7119
  • Fax: 575-339-2118
Mailing address:
  • Phone: 575-449-7119
  • Fax: 575-339-2118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHELLY R NOE
Title or Position: OWNER
Credential: DNP, PMHNP-BC
Phone: 575-449-7119