Provider Demographics
NPI:1891025649
Name:MCGUIRE, AMBER DESHAY (APN)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:DESHAY
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 SPRINGHILL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-7568
Mailing Address - Country:US
Mailing Address - Phone:501-847-2500
Mailing Address - Fax:
Practice Address - Street 1:2301 SPRINGHILL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019-7568
Practice Address - Country:US
Practice Address - Phone:501-847-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01910363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics