SHASTIDY PAULINE LOPEZ

TIJERAS, NM
NPI1962273854
Former NameSHASTIDY PAULINE MADRID
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171000000X Military Health Care Provider
Enumeration Date2024-01-10
Last Update Date2024-09-26
Business Address
SHASTIDY PAULINE LOPEZ CCSS
1 CAMINO ORO CT
TIJERAS, NM 87059-7924
Phone number: 706-593-8731
Mailing Address
SHASTIDY PAULINE LOPEZ CCSS
PO BOX 45681
RIO RANCHO, NM 87174-5681
Phone number: 505-226-1960