Provider Demographics
NPI:1093123119
Name:GUERRERO, ARMANDO JORGE JESSE (PA-C)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:JORGE JESSE
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20291 COOLGREEN RD
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:VA
Mailing Address - Zip Code:24236-4131
Mailing Address - Country:US
Mailing Address - Phone:304-712-1221
Mailing Address - Fax:
Practice Address - Street 1:20291 COOLGREEN RD
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:VA
Practice Address - Zip Code:24236-4131
Practice Address - Country:US
Practice Address - Phone:304-712-1221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-01
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004886363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical