Provider Demographics
NPI:1285074369
Name:GUEDON, GENNA YELVERTON (NP)
Entity type:Individual
Prefix:
First Name:GENNA
Middle Name:YELVERTON
Last Name:GUEDON
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 1:46 SEARGENT DR STE 203
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-4755
Mailing Address - Country:US
Mailing Address - Phone:601-445-7773
Mailing Address - Fax:601-445-5911
Practice Address - Street 1:46 SEARGENT DR STE 203
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-4755
Practice Address - Country:US
Practice Address - Phone:601-445-7773
Practice Address - Fax:601-445-5911
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR884563363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily