Provider Demographics
NPI:1417017856
Name:GUINAN, MARY (ARNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:GUINAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 45TH ST
Mailing Address - Street 2:STE 207
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2026
Mailing Address - Country:US
Mailing Address - Phone:561-842-9550
Mailing Address - Fax:561-842-9114
Practice Address - Street 1:2151 45TH ST
Practice Address - Street 2:STE 207
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2026
Practice Address - Country:US
Practice Address - Phone:561-842-9550
Practice Address - Fax:561-842-9114
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP623162363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY4210YMedicare PIN