Provider Demographics
NPI:1740444934
Name:SHELQUIST, VICKIE LYNNE (NP-C, FNP)
Entity type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:LYNNE
Last Name:SHELQUIST
Suffix:
Gender:F
Credentials:NP-C, FNP
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Mailing Address - Street 1:2340 HWY 180E
Mailing Address - Street 2:PMB 239
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-8806
Mailing Address - Country:US
Mailing Address - Phone:303-915-7712
Mailing Address - Fax:575-342-5010
Practice Address - Street 1:138 WENDY RD
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-9789
Practice Address - Country:US
Practice Address - Phone:303-915-7712
Practice Address - Fax:575-342-5010
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMCNP-03264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily