Individual provider Active NPI

Shaylee Rose Klock, FNP-C

  • Family Nurse Practitioner
  • Farmington, NM
National Provider Identifier
1629973052
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
92364 Issued in NM
Practice address
802 E Navajo St
Farmington, NM 87401-9119
Phone
(505) 592-4617
NPI assigned
Oct 14, 2026
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 92364 NM Primary

Addresses

Primary practice location

802 E Navajo St
Farmington, NM 87401-9119

Mailing address

1915 N Wagner Ave
Farmington, NM 87401-4216
Phone (505) 330-1918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1791936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1629973052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 N WAGNER AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874014216",
            "telephone_number": "505-330-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 E NAVAJO ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874019119",
            "telephone_number": "505-592-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOCK",
        "first_name": "SHAYLEE",
        "middle_name": "ROSE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-14",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "92364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.