Provider Demographics
NPI:1982004230
Name:MCGUINN, MICHAEL SHANNON (FNP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SHANNON
Last Name:MCGUINN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 N LIMESTONE ST
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-4742
Mailing Address - Country:US
Mailing Address - Phone:864-487-1544
Mailing Address - Fax:864-487-1634
Practice Address - Street 1:1530 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-4742
Practice Address - Country:US
Practice Address - Phone:864-487-1544
Practice Address - Fax:864-487-1634
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-23
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19011363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily