Healthcare Provider Details

I. General information

NPI: 1548285745
Provider Name (Legal Business Name): DIANE ANTOINETTE GUIDA RN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 MARKET ST
WILMINGTON NC
28403-1218
US

IV. Provider business mailing address

207 NUN ST
WILMINGTON NC
28401-5019
US

V. Phone/Fax

Practice location:
  • Phone: 910-254-9898
  • Fax: 910-254-9818
Mailing address:
  • Phone: 910-254-9505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: