Provider Demographics
NPI:1144577586
Name:O'GUINN-CHARLES, JO LYNN (NP)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:LYNN
Last Name:O'GUINN-CHARLES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 CHAMPAGNOLLE RODD
Mailing Address - Street 2:LIFE TOUCH HOSPICE
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730
Mailing Address - Country:US
Mailing Address - Phone:870-862-0331
Mailing Address - Fax:
Practice Address - Street 1:2301 CHAMPAGNOLLE ROAD
Practice Address - Street 2:LIFE TOUCH HOSPICE
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-3125
Practice Address - Country:US
Practice Address - Phone:870-862-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03631363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology