Provider Demographics
NPI:1790026425
Name:WILSON-GUINTO, KAREN S (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:WILSON-GUINTO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:S
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:727 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:IL
Mailing Address - Zip Code:61944-2460
Mailing Address - Country:US
Mailing Address - Phone:217-465-8411
Mailing Address - Fax:
Practice Address - Street 1:2200 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944-2966
Practice Address - Country:US
Practice Address - Phone:217-463-4340
Practice Address - Fax:217-463-4342
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-009489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209-009489OtherNP LICENSE