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General NPI Number Information
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NPI Number | 1851818835
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Entity Type | Individual
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Provider Name | CYNTHIA I GUEDE APRN
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Gender | Female
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Dates
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Enumeration Date | 08/29/2017
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Last Update Date | 12/24/2024
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Provider Practice Location Address
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Address Line | 719 N WILLIAM KUMPF BLVD STE 400
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City | PEORIA
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State | IL
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Zip | 61605-2531
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Country | US
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Telephone | 309-624-8611
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Fax | 309-308-5972
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Provider Business Mailing Address
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Address Line | 719 N WILLIAM KUMPF BLVD STE 400
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City | PEORIA
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State | IL
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Zip | 61605-2531
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209016428
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | AP61155187
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 364SG0600X
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Taxonomy Name | Gerontology Clinical Nurse Specialist
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License Number | 277001139
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License Number State | IL
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