Provider Demographics
NPI:1700377991
Name:GUICO, HAIDEE MEJIA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:HAIDEE
Middle Name:MEJIA
Last Name:GUICO
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 1:2502 MORGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1807
Mailing Address - Country:US
Mailing Address - Phone:361-888-6782
Mailing Address - Fax:361-888-6788
Practice Address - Street 1:2418 MORGAN AVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1806
Practice Address - Country:US
Practice Address - Phone:361-883-3683
Practice Address - Fax:361-888-6788
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137467363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932154101OtherTYPE 2 NPI