Healthcare Provider Details

I. General information

NPI: 1851196323
Provider Name (Legal Business Name): ERIKA GUERRERO CHW, LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 ANTHONY DR
ANTHONY NM
88021-9325
US

IV. Provider business mailing address

PO BOX 3948
ANTHONY NM
88021-3948
US

V. Phone/Fax

Practice location:
  • Phone: 915-474-3689
  • Fax:
Mailing address:
  • Phone: 915-474-3689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number311235
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberG-1583
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: