Provider Demographics
NPI:1558884809
Name:GUINN, TAMBRA B (MSN, APRN, AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TAMBRA
Middle Name:B
Last Name:GUINN
Suffix:
Gender:F
Credentials:MSN, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CIRCLE DRIVE
Mailing Address - Street 2:STE 2307
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76119-1139
Mailing Address - Country:US
Mailing Address - Phone:817-889-5698
Mailing Address - Fax:817-231-0650
Practice Address - Street 1:2300 CIRCLE DR STE 2307
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119-8134
Practice Address - Country:US
Practice Address - Phone:817-889-5698
Practice Address - Fax:817-231-0650
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134478363L00000X, 363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care