Individual
MR. FERNANDO JAVIER GUILLEN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
826 ANTHONY DR., ANTHONY, NM 88021
(575) 201-5135
(575) 449-4052
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
75069
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
53565
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55025340
—
NM
Enumeration date
09/05/2018
Last updated
02/12/2025
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