Healthcare Provider Details

I. General information

NPI: 1255242822
Provider Name (Legal Business Name): PRISCILLA GUILLEN RN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4435 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7651
US

IV. Provider business mailing address

4435 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7651
US

V. Phone/Fax

Practice location:
  • Phone: 602-491-1997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number341388
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: