Provider Demographics
NPI:1548065196
Name:GUERRERO, AMBER (CHW, LPN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:CHW, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3948
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:NM
Mailing Address - Zip Code:88021-3948
Mailing Address - Country:US
Mailing Address - Phone:915-471-7802
Mailing Address - Fax:
Practice Address - Street 1:1170 N SOLANO DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-2371
Practice Address - Country:US
Practice Address - Phone:915-471-7802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM56512164W00000X
NMG-1579172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No164W00000XNursing Service ProvidersLicensed Practical Nurse