Provider Demographics
NPI:1386685063
Name:GUY, REBECCA DIANE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:DIANE
Last Name:GUY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8208 CARRIAGE XING
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3264
Mailing Address - Country:US
Mailing Address - Phone:423-667-3225
Mailing Address - Fax:
Practice Address - Street 1:8208 CARRIAGE XING
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3264
Practice Address - Country:US
Practice Address - Phone:423-667-3225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000008814367500000X
GARN100978367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered