Provider Demographics
NPI:1306395249
Name:GUILLEN, CLAUDIA ILLEANA (FNP)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:ILLEANA
Last Name:GUILLEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:CLAUDIA
Other - Middle Name:ILLEANA
Other - Last Name:GUILLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1130 PECAN DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5774
Mailing Address - Country:US
Mailing Address - Phone:817-458-3300
Mailing Address - Fax:
Practice Address - Street 1:1517 TEXAS DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-6327
Practice Address - Country:US
Practice Address - Phone:817-458-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-03
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131043363LF0000X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP131043OtherAPRN LICENSE NUMBER
586743ZJFYOtherMCR ID
TX374368401Medicaid