Provider Demographics
NPI:1962510743
Name:CARDEN, SHIMER S (CNS)
Entity Type:Individual
Prefix:
First Name:SHIMER
Middle Name:S
Last Name:CARDEN
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 EL PASO RD
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88345-6033
Mailing Address - Country:US
Mailing Address - Phone:575-630-8350
Mailing Address - Fax:
Practice Address - Street 1:710 AVENUE E
Practice Address - Street 2:CARRIZOZO HEALTH CENTER
Practice Address - City:CARRIZOZO
Practice Address - State:NM
Practice Address - Zip Code:88301
Practice Address - Country:US
Practice Address - Phone:505-648-2317
Practice Address - Fax:505-648-4113
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNS00062364S00000X
NMR21328207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM48675261Medicaid
S99267Medicare UPIN
NM48675261Medicaid