Healthcare Provider Details

I. General information

NPI: 1942629415
Provider Name (Legal Business Name): COURTNEY GUINYARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CARRIAGE LN
CHARLESTON SC
29407-6060
US

IV. Provider business mailing address

160 FOX SQUIRREL CIR
COLUMBIA SC
29209-4477
US

V. Phone/Fax

Practice location:
  • Phone: 843-604-4577
  • Fax:
Mailing address:
  • Phone: 803-576-2715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number221319
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number29930
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: