Healthcare Provider Details

I. General information

NPI: 1336299460
Provider Name (Legal Business Name): NANCY M SCHIESS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY M SCHIESS D.O.

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 JACKIE ST. SE, SUITE 104
RIO RANCHO NM
87124
US

IV. Provider business mailing address

1350 JACKIE ST. SE, SUITE 104
RIO RANCHO NM
87124
US

V. Phone/Fax

Practice location:
  • Phone: 505-238-2997
  • Fax: 505-544-4631
Mailing address:
  • Phone: 505-238-2997
  • Fax: 505-544-4631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA-957-92
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: