Provider Demographics
NPI:1467235051
Name:GUINNEE, KATHLEEN A (APRN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:GUINNEE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:CHANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 372
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-0372
Mailing Address - Country:US
Mailing Address - Phone:217-868-2812
Mailing Address - Fax:
Practice Address - Street 1:1000 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:MATTOON
Practice Address - State:IL
Practice Address - Zip Code:61938-4644
Practice Address - Country:US
Practice Address - Phone:217-258-2397
Practice Address - Fax:217-258-2107
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209028104363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health