IndividualActive
Shenan Lark
NPI 1104211655 · Private Vehicle · Angel Fire, NM
Provider details
- NPI number
- 1104211655
- Entity type
- Individual
- Primary specialty
- Private VehicleTransportation Services
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Transportation Services
- Personal Emergency Response Attendant146D00000X
Emergency Medical Service Providers
- Driver172A00000X
Other Service Providers
Practice location
28 Aspen St. # 205
Angel Fire, NM 87710
Phone: (505) 603-9282
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1522
Angel Fire, NM 87710-1522
Registry dates
- Enumerated
- 2015-04-01
- Last updated
- 2015-04-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.