Provider Demographics
NPI:1689936148
Name:GUYNN, NATALIE GRACE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:GRACE
Last Name:GUYNN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:GRACE
Other - Last Name:ELLMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2021 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2021 WALNUT ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-9205
Practice Address - Country:US
Practice Address - Phone:919-233-4451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006283363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily