Provider Demographics
NPI:1740299379
Name:GUINN, NANCY (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:GUINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 CONSTITUTION PL NE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-7643
Mailing Address - Country:US
Mailing Address - Phone:505-559-6024
Mailing Address - Fax:505-559-1155
Practice Address - Street 1:8100 CONSTITUTION PL NE
Practice Address - Street 2:SUITE 400
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7643
Practice Address - Country:US
Practice Address - Phone:505-559-6024
Practice Address - Fax:505-559-1155
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM99-146207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM201018562OtherPRESBYTERIAN HEALTH PLAN
NMNM009H60OtherBLUE CROSS/BLUE SHIELD NM
NMN0273Medicaid
NMN0273Medicaid
NM338323101Medicare PIN