Provider Demographics
NPI:1598748774
Name:GUYETT, LANCE C (ACNP)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:C
Last Name:GUYETT
Suffix:
Gender:M
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6460 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5838
Mailing Address - Country:US
Mailing Address - Phone:716-634-5100
Mailing Address - Fax:716-634-5134
Practice Address - Street 1:6460 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5838
Practice Address - Country:US
Practice Address - Phone:716-634-5100
Practice Address - Fax:716-634-5134
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430229363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00027207101OtherUNIVERA
NY000560947001OtherBLUE CORSS COMM BLUE
NY9512945OtherINDEP HEALTH
NY00027207101OtherUNIVERA