Provider Demographics
NPI:1740295211
Name:MCKERNAN, REBECCA GUEVARA (CNS, APN)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:GUEVARA
Last Name:MCKERNAN
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Gender:F
Credentials:CNS, APN
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Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:7801 ACADEMY RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3379
Practice Address - Country:US
Practice Address - Phone:505-272-2290
Practice Address - Fax:505-272-8982
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2012-07-10
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Provider Licenses
StateLicense IDTaxonomies
NMR17858208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery