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General NPI Number Information
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NPI Number | 1740532720
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Entity Type | Individual
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Provider Name | REBECCA LEE GUY MSN, APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 05/29/2015
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Provider Practice Location Address
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Address Line | 124 5TH ST STE A
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City | WILDER
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State | ID
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Zip | 83676-5542
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Country | US
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Telephone | 208-482-7430
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Fax | 208-482-7272
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Provider Business Mailing Address
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Address Line | 124 5TH ST STE A
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City | WILDER
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State | ID
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Zip | 83676-5542
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Country | US
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Telephone | 208-482-7430
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Fax | 208-482-7272
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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 | NP-1220A
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License Number State | ID
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