Provider Demographics
NPI:1689006660
Name:DE GUZMAN, ERIN NICOLE (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:NICOLE
Last Name:DE GUZMAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-286-1700
Mailing Address - Fax:314-970-9094
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DEPT PSYCHIATRY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-286-1700
Practice Address - Fax:314-970-9094
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2016005874363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420043056Medicaid