Provider Demographics
NPI:1407444029
Name:MCGUIRE, AMANDA HARPER (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:HARPER
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:625 RUSSELL BLVD
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1247
Mailing Address - Country:US
Mailing Address - Phone:936-305-5050
Mailing Address - Fax:936-305-5151
Practice Address - Street 1:625 RUSSELL BLVD
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1247
Practice Address - Country:US
Practice Address - Phone:936-305-5050
Practice Address - Fax:936-305-5151
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX779772163W00000X
TX1057680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse