Provider Demographics
NPI:1790197309
Name:GUIMOND, CHRISTINA L (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:L
Last Name:GUIMOND
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 1:907 E FAIRBAIRN DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-6955
Mailing Address - Country:US
Mailing Address - Phone:716-679-6706
Mailing Address - Fax:
Practice Address - Street 1:51 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:CASSADAGA
Practice Address - State:NY
Practice Address - Zip Code:14718-9704
Practice Address - Country:US
Practice Address - Phone:716-467-3923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-30
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9553835163WM0705X
NY315270164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical