Healthcare Provider Details

I. General information

NPI: 1154246775
Provider Name (Legal Business Name): GUADALUPE FALCON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87111-2310
US

IV. Provider business mailing address

8800 MONTGOMERY BLVD SW
ALBUQUERQUE NM
87111
US

V. Phone/Fax

Practice location:
  • Phone: 505-462-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: