Healthcare Provider Details

I. General information

NPI: 1831911858
Provider Name (Legal Business Name): GENEVIEVE GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 HOLIDAY DR STE 110
PITTSBURGH PA
15220-2769
US

IV. Provider business mailing address

655 BRAWLEY SCHOOL RD STE 200
MOORESVILLE NC
28117-9601
US

V. Phone/Fax

Practice location:
  • Phone: 412-503-9842
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP031070
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: