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General NPI Number Information
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NPI Number | 1912744343
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Entity Type | Individual
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Provider Name | SHANNEIL SERENE GUZMAN APRN
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Gender | Female
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Dates
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Enumeration Date | 07/12/2024
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 106 IRVING ST NW STE 4100
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City | WASHINGTON
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State | DC
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Zip | 20010-2971
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Country | US
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Telephone | 202-726-0941
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Fax | 301-593-9036
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Provider Business Mailing Address
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Address Line | PO BOX 749495
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City | ATLANTA
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State | GA
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Zip | 30374-9495
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Country | US
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Telephone | 855-963-2100
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Fax | 239-236-2775
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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 | R223701
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License Number State | MD
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