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General NPI Number Information
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NPI Number | 1588558399
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Entity Type | Individual
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Provider Name | JENNIFER GUARDADO FNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 213 MIDDLEBURY ST
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City | GOSHEN
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State | IN
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Zip | 46528-2956
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Country | US
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Telephone | 574-534-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 57788 AMBER VALLEY DR
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City | ELKHART
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State | IN
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Zip | 46517-8671
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Country | US
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Telephone | 574-903-3937
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71016979A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28245086A
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License Number State | IN
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