Shannon King, ADN
Individual provider Active NPI Addiction (Substance Use Disorder) Registered Nurse · Los Ranchos, NM
NPI 1043558331 · NPPES record last updated Sep 20, 2023
Key facts
- NPI
- 1043558331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Registered Nurse 163WA0400X
- License
- R52018 (NM)
- Practice address
- 8200 Guadalupe TRL NW
Los Ranchos, NM 87114-1121 - Phone
- (505) 898-3666
- NPI assigned
- Jan 22, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R52018 | NM | MD | Addiction (Substance Use Disorder) Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | R52018 | NM | |
| Addiction (Substance Use Disorder) Registered Nurse | 163WA0400X | R52018 | NM | Yes |
Addresses
Primary practice location
8200 Guadalupe TRL NW
Los Ranchos, NM 87114-1121
Mailing address
7500 Target LN NW
Albuquerque, NM 87120-3065
Phone (505) 550-7303
Other providers in Los Ranchos, NM
- Stacy Lee Johnson
- K-Drugs Inc
- Kidsbridge
- Kidsbridge Occupational Therapy
- Jocelyn Kim
- Knackstedt Medical Group Inc.
- Shirley Knackstedt
- Sedona Kolchinsky
- Jacob Kualapai
- Charlotte Latham
All providers in Los Ranchos, NM · Addiction (Substance Use Disorder) Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.