Shastidy Pauline Lopez, CCSS
NPI #1962273854 in Tijeras, New Mexico
Provider Information
- NPI Number
- 1962273854
- Entity Type
- Individual
- Name
- Shastidy Pauline Lopez, CCSS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Military Health Care Provider
- Credential
- CCSS
- Enumeration Date
- Jan 10, 2024
- Last Updated
- Sep 26, 2024
Practice Location
- Address
- 1 CAMINO ORO CT
- City
- Tijeras
- State
- New Mexico
- ZIP Code
- 87059-7924
- Phone
- (706) 593-8731
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider |
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