Provider Demographics
NPI:1790485498
Name:GUZMAN, EDILENIE (RN)
Entity Type:Individual
Prefix:
First Name:EDILENIE
Middle Name:
Last Name:GUZMAN
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 1:60 NEWBURY AVE
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-6523
Mailing Address - Country:US
Mailing Address - Phone:978-918-3959
Mailing Address - Fax:
Practice Address - Street 1:60 NEWBURY AVE
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-6523
Practice Address - Country:US
Practice Address - Phone:978-918-3959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2341068163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse