Provider Demographics
NPI:1922674522
Name:GUEVARA, BRANIESNEY (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRANIESNEY
Middle Name:
Last Name:GUEVARA
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:BRANIESNEY
Other - Middle Name:
Other - Last Name:ORTIZ CAMACHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1119 CHERRYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-4503
Mailing Address - Country:US
Mailing Address - Phone:612-393-6636
Mailing Address - Fax:
Practice Address - Street 1:1119 CHERRYWOOD CT
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-4503
Practice Address - Country:US
Practice Address - Phone:612-393-6636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-03
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11705394-4405363LF0000X
MN8304363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily