Healthcare Provider Details
I. General information
NPI: 1689527178
Provider Name (Legal Business Name): MONCURE HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/16/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
110 E 11TH ST
SILVER CITY NM
88061-5510
US
IV. Provider business mailing address
16 LA MONTANA
SILVER CITY NM
88061-9289
US
V. Phone/Fax
- Phone: 772-708-8476
- Fax:
- Phone: 772-708-8476
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHANNON
MARIE
MONCURE
Title or Position: OWNER
Credential: APRN, FNP-C
Phone: 772-708-8476