Organization
NMVAHCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CATHLEEN GUILLEN R.D. (RENAL DIETITIAN)
(505) 265-1711
Entity
Organization
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
379
NM
Other
Enumeration date
07/01/2006
Last updated
08/22/2020
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