Provider Demographics
NPI:1740788041
Name:GUERRERO, ANA MARISSA (RN)
Entity Type:Individual
Prefix:
First Name:ANA MARISSA
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13313 OLD COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5233
Mailing Address - Country:US
Mailing Address - Phone:443-923-4170
Mailing Address - Fax:443-923-4181
Practice Address - Street 1:13313 OLD COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5233
Practice Address - Country:US
Practice Address - Phone:443-923-4170
Practice Address - Fax:443-923-4181
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR123406163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse