Provider Demographics
NPI:1114578168
Name:GUINN, CANDANCE MARIE (PMHNP-BC, APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:CANDANCE
Middle Name:MARIE
Last Name:GUINN
Suffix:
Gender:F
Credentials:PMHNP-BC, APRN-CNP
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 11898
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-0037
Mailing Address - Country:US
Mailing Address - Phone:870-639-9322
Mailing Address - Fax:501-492-6477
Practice Address - Street 1:1906 W HILLSBORO ST STE B
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730
Practice Address - Country:US
Practice Address - Phone:870-639-9322
Practice Address - Fax:501-492-6477
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR122196363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR12296OtherAPRN LICENSE
AR5FG01OtherBCBS
14569857OtherCAQH PROVIDER ID