Provider Demographics
NPI:1922588631
Name:WOJTUSIK, KIMBERLY GUFFEY (ARNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:GUFFEY
Last Name:WOJTUSIK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-3010
Mailing Address - Country:US
Mailing Address - Phone:561-801-0976
Mailing Address - Fax:
Practice Address - Street 1:355 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-3010
Practice Address - Country:US
Practice Address - Phone:561-801-0976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2844662363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner