Healthcare Provider Details

I. General information

NPI: 1700120862
Provider Name (Legal Business Name): JOYCE MARIE GUINNESS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 NAVARRE AVE PAIN CLINIC
OREGON OH
43616-3207
US

IV. Provider business mailing address

2200 JEFFERSON AVE 4TH FLOOR
TOLEDO OH
43604-7101
US

V. Phone/Fax

Practice location:
  • Phone: 419-696-7646
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA.03475-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: