Provider Demographics
NPI:1003076803
Name:GUIGNARD, STEPHANIE DEANNE (CPNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DEANNE
Last Name:GUIGNARD
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6421 PAMILLA LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6386
Mailing Address - Country:US
Mailing Address - Phone:201-240-3650
Mailing Address - Fax:
Practice Address - Street 1:6421 PAMILLA LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6386
Practice Address - Country:US
Practice Address - Phone:201-240-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-15
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382122363LP0200X
TX683962163W00000X
TXAP123002363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse