Healthcare Provider Details

I. General information

NPI: 1992511190
Provider Name (Legal Business Name): CHELSEA ROSE GUYOT MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6558 W SCHMIDT ST
GLENDALE AZ
85308-1057
US

IV. Provider business mailing address

2151 W BEHREND DR
PHOENIX AZ
85027-4125
US

V. Phone/Fax

Practice location:
  • Phone: 480-710-4707
  • Fax:
Mailing address:
  • Phone: 480-710-4707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number316290
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberLNA1000043009
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number316290
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: