Provider Demographics
NPI:1568167179
Name:OGLE SCHWENT, SHELLY (RN, MSN)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:
Last Name:OGLE SCHWENT
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 AVENIDA TORREON
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-8852
Mailing Address - Country:US
Mailing Address - Phone:505-467-4905
Mailing Address - Fax:
Practice Address - Street 1:2 AVENIDA TORREON
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-8852
Practice Address - Country:US
Practice Address - Phone:505-467-4905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR53962163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool