James B Guynn, CFNP

Individual provider Active NPI Family Nurse Practitioner · Bloomfield, NM

NPI 1497786354 · NPPES record last updated Feb 24, 2020

Key facts

NPI
1497786354
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
CNP00126 (NM)
Practice address
100 N Church St Ste C
Bloomfield, NM 87413-5754
Phone
(505) 609-6675
Fax
(505) 609-6579
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP00126 NM Yes

Addresses

Primary practice location

100 N Church St Ste C
Bloomfield, NM 87413-5754

Mailing address

PO Box 6210
Farmington, NM 87499-6210
Phone (505) 609-2258

Other practice location 1

4820 E Main St
Farmington, NM 87402-8660
Phone (505) 609-6495

Other identifiers

IdentifierTypeStateIssuer
09228772MedicaidNM

Other providers in Bloomfield, NM

All providers in Bloomfield, NM · Family Nurse Practitioner in New Mexico

Sources for this page

Verify at the official NPI Registry.