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NPI Code Detail

MEDICARE: DIETTA L GUESS APRN

MEDICARE: DIETTA L GUESS APRN
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
1363L00000XNurse Practitioner2151PKY

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 : 1235193103
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIETTA L GUESS APRN
Provider Business Mailing Address
First Line : 713 W MAIN ST
Second Line :
City : ELKTON
State : KY
Zip : 42220-9229
Country : US
Telephone Number : 270-265-5353
Fax Number : 270-265-5350
Provider Business Practice Location Address
First Line : 713 W MAIN ST
Second Line :
City : ELKTON
State : KY
Zip : 42220-9229
Country : US
Telephone Number : 270-265-5353
Fax Number : 270-265-5350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2006
Last Update Date : 07/29/2014

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Directions to “ DIETTA L GUESS APRN” Practice Location

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