| Doctor Name: | PATRICK KEENAN SHANLEY |
| NPI Number: | 1033386420 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA2008-0045 |
| Business Practice Address: | 1219 Gusdorf Rd Ste A Taos, NM - 875716499 |
| Business Phone Number: | 5057580009 |
| Business Fax Number: | 5057588736 |
| Mailing Address: | 1219 Gusdorf Rd Ste A, TAOS |
| State: | NM |
| Postal Code: | 875716499 |
| Phone Number: | 5057580009 |
| Fax Number: | 5057588736 |
| NPI Enumeration Date: | 05/14/2008 |
| NPI Last Update Date: | 03/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA2008-0045 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |