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General NPI Number Information
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NPI Number | 1962772269
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Entity Type | Individual
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Provider Name | GLORIA MICHELLE GUESS APRN
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Gender | Female
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 121 WHITEHALL DR
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5266
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Country | US
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Telephone | 907-825-4500
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Fax | 904-825-3672
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Provider Business Mailing Address
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Address Line | 7015 A C SKINNER PKWY STE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6932
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Country | US
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Telephone | 904-363-2113
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Fax | 904-363-2606
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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 | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | APRN9194629
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN9194629
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 364SX0200X
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Taxonomy Name | Oncology Clinical Nurse Specialist
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License Number | APRN9194629
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9194629
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License Number State | FL
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