Healthcare Provider Details

I. General information

NPI: 1891661864
Provider Name (Legal Business Name): GUADALUPE GUERRERO LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/24/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 N MAIN ST STE 5
LAS CRUCES NM
88001-1136
US

IV. Provider business mailing address

2146 FRONTIER DR
LAS CRUCES NM
88011-9038
US

V. Phone/Fax

Practice location:
  • Phone: 575-312-0486
  • Fax:
Mailing address:
  • Phone: 575-312-0486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0123
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: