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NPI Code Detail

MEDICARE: MRS. SHAWNA BAILEY RN

MEDICARE:  MRS. SHAWNA  BAILEY  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WS0200XSchool Registered NurseR55604NM

General Provider Information

NPI Number : 1720409832
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHAWNA BAILEY RN
Provider Business Mailing Address
First Line : 505 S MAIN ST
Second Line : STE 249
City : LAS CRUCES
State : NM
Zip : 88001-1206
Country : US
Telephone Number : 575-527-5884
Fax Number : 575-527-5886
Provider Business Practice Location Address
First Line : 1955 N VALLEY DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-5154
Country : US
Telephone Number : 575-527-9415
Fax Number : 575-527-9420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2013
Last Update Date : 12/17/2013

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Directions to “ MRS. SHAWNA BAILEY RN” Practice Location

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