Provider Demographics
NPI:1417730441
Name:GUYNN, JOSHUA ROBERT (MSN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ROBERT
Last Name:GUYNN
Suffix:
Gender:M
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 E COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-0963
Mailing Address - Country:US
Mailing Address - Phone:317-292-6686
Mailing Address - Fax:
Practice Address - Street 1:1402 E COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-0963
Practice Address - Country:US
Practice Address - Phone:317-292-6686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28201626C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily