Healthcare Provider Details

I. General information

NPI: 1417812066
Provider Name (Legal Business Name): RICHARD ALLEN MCGUIRE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SPRING ST STE B
JEFFERSONVILLE IN
47130-2930
US

IV. Provider business mailing address

449 WOODLAND PASS
MOUNT WASHINGTON KY
40047-5822
US

V. Phone/Fax

Practice location:
  • Phone: 812-284-2273
  • Fax:
Mailing address:
  • Phone: 812-284-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4049450
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: