Provider Demographics
NPI:1598040685
Name:GUILL, MARIAN DEATON (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:DEATON
Last Name:GUILL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5429 WRIGHTSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6513
Mailing Address - Country:US
Mailing Address - Phone:910-792-1001
Mailing Address - Fax:910-792-1004
Practice Address - Street 1:5429 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6513
Practice Address - Country:US
Practice Address - Phone:910-792-1001
Practice Address - Fax:910-792-1004
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily