Healthcare Provider Details

I. General information

NPI: 1023844941
Provider Name (Legal Business Name): ROBERTO GUERRERO JR. RN-BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 NORTHWESTERN DR
EL PASO TX
79912-1122
US

IV. Provider business mailing address

PO BOX 3948
ANTHONY NM
88021-3948
US

V. Phone/Fax

Practice location:
  • Phone: 915-877-5800
  • Fax:
Mailing address:
  • Phone: 915-549-7913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN-73380
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: