Healthcare Provider Details

I. General information

NPI: 1720795842
Provider Name (Legal Business Name): CAILEE GUIDER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1676 SUNSET AVE
UTICA NY
13502-5416
US

IV. Provider business mailing address

2209 GENESEE ST BUSINESS OFFICE ROOM 315
UTICA NY
13501
US

V. Phone/Fax

Practice location:
  • Phone: 315-624-5252
  • Fax:
Mailing address:
  • Phone: 315-801-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number350651
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704452346
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024198813
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: