Healthcare Provider Details

I. General information

NPI: 1275800815
Provider Name (Legal Business Name): JOCELYN HILARY MCGUIRE RN, MSN, APN, ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOCELYN HILARY STAUFFER RN, MSN, APN, ANP-BC

II. Dates (important events)

Enumeration Date: 11/28/2011
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3991 DUTCHMANS LN STE 310
LOUISVILLE KY
40207-4716
US

IV. Provider business mailing address

PO BOX 776351
CHICAGO IL
60677-6351
US

V. Phone/Fax

Practice location:
  • Phone: 502-899-6782
  • Fax:
Mailing address:
  • Phone: 502-588-9490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3016045
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16337
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP020161
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3016045
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: