Provider Demographics
NPI:1275398794
Name:GUYMON, MADALYN (FNP-C)
Entity Type:Individual
Prefix:
First Name:MADALYN
Middle Name:
Last Name:GUYMON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38012-4113
Mailing Address - Country:US
Mailing Address - Phone:731-734-2023
Mailing Address - Fax:877-753-3133
Practice Address - Street 1:511 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012-4113
Practice Address - Country:US
Practice Address - Phone:731-734-2023
Practice Address - Fax:877-753-3133
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN246009163W00000X
TN35723363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse