Provider Demographics
NPI:1174254411
Name:GUARNERA, SHELLEY DAWN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:DAWN
Last Name:GUARNERA
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 1:8804 ROZETTA CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6179
Mailing Address - Country:US
Mailing Address - Phone:702-241-8599
Mailing Address - Fax:
Practice Address - Street 1:911 N BUFFALO DR UNIT 213
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0381
Practice Address - Country:US
Practice Address - Phone:702-241-8599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV854036363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health