Individual
JACQUELYNN LOPEZ GUERIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10124 COORS BLVD NW, ALBUQUERQUE, NM 87114
(505) 263-8622
Mailing address
10705 FLAGSTONE PL NW, ALBUQUERQUE, NM 87114-3995
(505) 263-8622
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
65744
NM
Other
Enumeration date
11/09/2022
Last updated
11/09/2022
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