IndividualActive
Shastidy Lopez, CCSS
NPI 1962273854 · Military Health Care Provider · Tijeras, NM
Provider details
- NPI number
- 1962273854
- Entity type
- Individual
- Primary specialty
- Military Health Care ProviderOther Service Providers
- Credential
- CCSS
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
1 Camino Oro Ct
Tijeras, NM 87059-7924
Phone: (706) 593-8731
Fax: (706) 593-8732
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 45681
Rio Rancho, NM 87174-5681
Registry dates
- Enumerated
- 2024-01-10
- Last updated
- 2024-09-26
- Certified
- 2024-09-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.