Healthcare Provider Details

I. General information

NPI: 1932360229
Provider Name (Legal Business Name): MARIA D GUZMAN RN CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ORONDO AVE SUITE 1
WENATCHEE WA
98801-2800
US

IV. Provider business mailing address

600 ORONDO AVE SUITE 1
WENATCHEE WA
98801-2800
US

V. Phone/Fax

Practice location:
  • Phone: 509-664-3524
  • Fax: 509-664-4590
Mailing address:
  • Phone: 509-664-3524
  • Fax: 509-664-4590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN00117837
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: