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NPI Code Detail

MEDICARE: KATHLEEN SUE GUETSCHOFF NP

MEDICARE: KATHLEEN SUE GUETSCHOFF NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse PractitionerR108568-4MN
2363LW0102XWomen's Health Nurse Practitioner20896SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134182066
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN SUE GUETSCHOFF NP
Provider Business Mailing Address
First Line : 1 INDEPENDENCE PT STE 212
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-4536
Country : US
Telephone Number : 864-797-6306
Fax Number :
Provider Business Practice Location Address
First Line : 1120 GROVE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29605-4656
Country : US
Telephone Number : 864-455-8802
Fax Number : 864-455-8555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 04/19/2017

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