Provider Demographics
NPI:1083262349
Name:MCGUIRE, LAWANNA LANAE (APRN)
Entity Type:Individual
Prefix:
First Name:LAWANNA
Middle Name:LANAE
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-218-3516
Mailing Address - Fax:606-218-4540
Practice Address - Street 1:911 BYPASS RD BLDG A
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1689
Practice Address - Country:US
Practice Address - Phone:606-218-3516
Practice Address - Fax:606-218-4540
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2282825OtherWELLCARE OF KY PROVIDER ID NUMBER
KY7100686320Medicaid
CS2027500198OtherCARESOURCE PROVIDER ID NUMBER
PDZ000000623080OtherAETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
000001412352OtherANTHEM PROVIDER ID NUMBER
14604528OtherCAQH PROVIDER ID
7473477OtherUNITED HEALTHCARE PROVIDER ID NUMBER