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General NPI Number Information
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NPI Number | 1508531435
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Entity Type | Individual
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Provider Name | SHANTAL AIME GIRON NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 1202 MAIN ST NE STE A
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City | LOS LUNAS
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State | NM
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Zip | 87031-7421
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Country | US
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Telephone | 505-565-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 7201 VILLA TULIPAN NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-1194
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Country | US
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Telephone | 505-553-8586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 59604
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License Number State | NM
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