SHASTIDY PAULINE LOPEZ CCSS
NPI 1962273854
Military Health Care Provider in Tijeras, NM

Q: What is the provider's specialty?

The provider's specialty is Military Health Care Provider with taxonomy code 171000000X.

Active since January 10, 2024

1 CAMINO ORO CT, TIJERAS, NM 87059(706) 593-8731(706) 593-8732 Get Directions Write a Review

NPPES record last updated: September 26, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Shastidy Pauline Lopez Ccss NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHASTIDY PAULINE LOPEZ CCSS (NPI 1962273854) is an individual military health care provider provider in Tijeras, New Mexico and active in the NPI registry since January 2024.

NPPES Registry Identity

NPI1962273854

Entity TypeIndividualFemale

Primary Taxonomy171000000X

Provider Legal NameSHASTIDY PAULINE LOPEZCredential: CCSS

Location Address1 CAMINO ORO CTTijeras, NM 87059-7924

Mailing AddressPo Box 45681Rio Rancho, NM 87174-5681 · (505) 226-1960 · Fax (505) 672-7769

Phone(706) 593-8731

Fax(706) 593-8732

Sole ProprietorNo

Enumeration DateJanuary 10, 2024

Last NPPES UpdateSeptember 26, 2024

NPPES CertifiedSeptember 26, 2024

✔ NPI 1962273854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care ProviderOther Service Providers

Taxonomy Code171000000X

Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

1 CAMINO ORO CT, Tijeras, NM 87059

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