Healthcare Provider Details

I. General information

NPI: 1538875059
Provider Name (Legal Business Name): MARTHA GUZMAN APRN, FNP-BC, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2023
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 SEQUOIA AVE
LINDSAY CA
93247-1424
US

IV. Provider business mailing address

222 W HENDERSON AVE
PORTERVILLE CA
93257-1731
US

V. Phone/Fax

Practice location:
  • Phone: 559-562-1361
  • Fax:
Mailing address:
  • Phone: 559-784-5483
  • Fax: 559-789-9828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95024049
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: