MEDICARE: GUADALUPE IVONNE ARMENTA CARRASCO APRN-CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1074709	TX
2	163W00000X	Registered Nurse	852848	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NONE	OTHER		NONE

General Provider Information

NPI Number	:	1780392365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUADALUPE IVONNE ARMENTA CARRASCO APRN-CNP

Provider Business Mailing Address
First Line	:	7500 VISCOUNT BLVD
Second Line	:	SUITE 298
City	:	EL PASO
State	:	TX
Zip	:	79925
Country	:	US
Telephone Number	:	915-200-2694
Fax Number	:	915-521-2278

Provider Business Practice Location Address
First Line	:	1540 N ZARAGOZA RD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7905
Country	:	US
Telephone Number	:	915-592-3323
Fax Number	:	915-593-8571

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2022
Last Update Date	:	06/11/2026

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