Healthcare Provider Details

I. General information

NPI: 1740881200
Provider Name (Legal Business Name): GUYLANTE JEUNE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E HOWARD ST
CLAYTON NJ
08312-1237
US

IV. Provider business mailing address

121 E HOWARD ST
CLAYTON NJ
08312-1237
US

V. Phone/Fax

Practice location:
  • Phone: 786-469-0304
  • Fax:
Mailing address:
  • Phone: 786-469-0304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF10201178
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF404746
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: