MEDICARE: JOY JEREZA DE GUZMAN FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	AP127888	TX

General Provider Information

NPI Number	:	1891173431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY JEREZA DE GUZMAN FNP-BC

Provider Business Mailing Address
First Line	:	8008 GERANIUM LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-1893
Country	:	US
Telephone Number	:	817-361-9112
Fax Number	:

Provider Business Practice Location Address
First Line	:	8008 GERANIUM LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-1893
Country	:	US
Telephone Number	:	817-361-9112
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2015
Last Update Date	:	02/25/2022

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