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General NPI Number Information
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NPI Number | 1043787070
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Entity Type | Individual
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Provider Name | AMANDA RUTH GUISE-MCDONOUGH CNP
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Gender | Female
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Dates
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Enumeration Date | 10/29/2018
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 2801 S OLIVE ST STE 33
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City | PINE BLUFF
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State | AR
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Zip | 71603-5413
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Country | US
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Telephone | 870-806-3905
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Fax | 855-576-4093
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone | 888-987-1151
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | A005720
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | A005720
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License Number State | AR
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