Provider Demographics
NPI:1942306501
Name:SHEY, LYNDA CAROLE (APRN, BC-ADM)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:CAROLE
Last Name:SHEY
Suffix:
Gender:F
Credentials:APRN, BC-ADM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SANDOVAL RD SW
Mailing Address - Street 2:RIO ABAJO FAMILY PRACTICE
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-7320
Mailing Address - Country:US
Mailing Address - Phone:505-565-4355
Mailing Address - Fax:505-565-4360
Practice Address - Street 1:111 SANDOVAL RD SW
Practice Address - Street 2:RIO ABAJO FAMILY PRACTICE
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-7320
Practice Address - Country:US
Practice Address - Phone:505-565-4355
Practice Address - Fax:505-565-4360
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNS00145364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical