Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANNON MONIQUE MEDINA
ActiveSHANNON MONIQUE MEDINA is a Social Worker healthcare provider located in PENASCO, New Mexico. NPI 1366092645 is currently active in the NPPES registry. Verify at CMS.
Social Worker · PENASCO, NM
Registration Details
- NPI Number
- 1366092645
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 18, 2019 (6.7603731688074 yrs)
- Last Updated
- Sep 18, 2019
- Licenses
-
376369 (NM)X-11248 (NM)
Practice Information
- Address
-
13 OLD SCHOOL RDPENASCO, NM, 87553Browse NM providers · Browse ZIP 87553
- Phone
- 5755872502
- Primary Specialty
-
Social Worker
104100000X
- Additional Specialty
- Social Worker
Other Social Worker Providers in PENASCO, NM
| Name | Credential | NPI |
|---|---|---|
| LORI BETH GOMEZ | LMSW, LADAC | 1083959845 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.