Healthcare Provider Details

I. General information

NPI: 1710872668
Provider Name (Legal Business Name): AMY MARIE GUARINO MSN, RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAINT ANTHONYS WAY
ALTON IL
62002-4568
US

IV. Provider business mailing address

29 GREER ST
EAST ALTON IL
62024-1823
US

V. Phone/Fax

Practice location:
  • Phone: 618-465-2571
  • Fax:
Mailing address:
  • Phone: 618-830-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041382303
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: