Provider Demographics
NPI:1760102123
Name:GUISINGER, DREW WILLIAM
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:WILLIAM
Last Name:GUISINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SAPPHIRE ST
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:OH
Mailing Address - Zip Code:45302-8503
Mailing Address - Country:US
Mailing Address - Phone:937-638-9585
Mailing Address - Fax:
Practice Address - Street 1:1103 FAIRINGTON DR STE 100
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-8130
Practice Address - Country:US
Practice Address - Phone:937-497-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032393363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily