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General NPI Number Information
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NPI Number | 1184511008
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Entity Type | Individual
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Provider Name | KAMME GUISTO PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 1001 E 2ND ST
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City | COUDERSPORT
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State | PA
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Zip | 16915-8161
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Country | US
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Telephone | 814-274-5320
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Fax |
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Provider Business Mailing Address
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Address Line | 259 ALPINE WAY
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City | EMPORIUM
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State | PA
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Zip | 15834-3805
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Country | US
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Telephone | 814-562-0361
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA066830
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License Number State | PA
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