Healthcare Provider Details

I. General information

NPI: 1699958280
Provider Name (Legal Business Name): SAMANTHA SHALEY EVANS GERMANY BSN CPM CA-SANE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAMANTHA SHALEY GERMANY LM CPM BSN-SDNP

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 N RIDGE LOOP DR
SILVER CITY NM
88061-7243
US

IV. Provider business mailing address

3201 N RIDGE LOOP DR
SILVER CITY NM
88061-7243
US

V. Phone/Fax

Practice location:
  • Phone: 512-749-8708
  • Fax: 737-263-1804
Mailing address:
  • Phone: 512-749-8708
  • Fax: 737-263-1804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1100555
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25001R
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: