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General NPI Number Information
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NPI Number | 1417958711
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Entity Type | Individual
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Provider Name | MARY ANN MCGUIRE CFNP
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Gender | Female
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 1627 S UNION AVE
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City | ROSWELL
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State | NM
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Zip | 88203-2656
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Country | US
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Telephone | 575-208-0106
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Fax | 575-208-0700
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Provider Business Mailing Address
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Address Line | 1717 W 2ND ST STE 101
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City | ROSWELL
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State | NM
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Zip | 88201-2000
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Country | US
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Telephone | 575-627-1200
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Fax | 888-445-1844
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R38408
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License Number State | NM
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