MEDICARE: STACY GUAY PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	CNP201289	ME

General Provider Information

NPI Number	:	1760090997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY GUAY PMHNP

Provider Business Mailing Address
First Line	:	PO BOX 1595
Second Line	:
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-8095
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 MEMORIAL CIR
Second Line	:
City	:	AUGUSTA
State	:	ME
Zip	:	04330-6400
Country	:	US
Telephone Number	:	860-788-6404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2020
Last Update Date	:	03/26/2026

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