Provider Demographics
NPI:1760701080
Name:GUESS, KATIE (NP-C)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:GUESS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CAHABA VALLEY PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1185
Mailing Address - Country:US
Mailing Address - Phone:205-733-1130
Mailing Address - Fax:205-560-0451
Practice Address - Street 1:120 CAHABA VALLEY PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1185
Practice Address - Country:US
Practice Address - Phone:205-733-1130
Practice Address - Fax:205-560-0451
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-109687363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily