Provider Demographics
NPI:1942395132
Name:GUGGENBILLER, MADONNA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:MADONNA
Middle Name:MARIE
Last Name:GUGGENBILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 CEREAL AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-2784
Mailing Address - Country:US
Mailing Address - Phone:513-867-2811
Mailing Address - Fax:513-867-2094
Practice Address - Street 1:1010 CEREAL AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2784
Practice Address - Country:US
Practice Address - Phone:513-867-2811
Practice Address - Fax:513-867-2094
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN240711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHGUNP05582Medicare ID - Type Unspecified