Individual provider · Type 1 NPI
Shenan Lark
Private Vehicle · Angel Fire, NM
NPI number
1104211655
Active
Practice location
28 Aspen St. # 205
Angel Fire, NM 87710
Mailing address
PO Box 1522
Angel Fire, NM 87710-1522
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Personal Emergency Response Attendant | 146D00000X | None listed |
| Driver | 172A00000X | None listed |
| Private Vehicle Primary | 347C00000X | None listed |
Private Vehicle: An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
About NPI 1104211655
Shenan Lark's National Provider Identifier is 1104211655, issued on Apr 1, 2015. The primary taxonomy on file is Private Vehicle (347C00000X), and the practice location is in Angel Fire, NM. The record was last updated on Apr 1, 2015.