Healthcare Provider Details

I. General information

NPI: 1740299379
Provider Name (Legal Business Name): NANCY GUINN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 CONSTITUTION PL NE SUITE 400
ALBUQUERQUE NM
87110-7643
US

IV. Provider business mailing address

8100 CONSTITUTION PL NE SUITE 400
ALBUQUERQUE NM
87110-7643
US

V. Phone/Fax

Practice location:
  • Phone: 505-559-6024
  • Fax: 505-559-1155
Mailing address:
  • Phone: 505-559-6024
  • Fax: 505-559-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number99-146
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: