Provider Demographics
NPI:1447872320
Name:GUERARD, IRINA (A-GNP)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:GUERARD
Suffix:
Gender:
Credentials:A-GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 RIDGECLIFF CT
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21087-1253
Mailing Address - Country:US
Mailing Address - Phone:251-213-3066
Mailing Address - Fax:
Practice Address - Street 1:12 RIDGECLIFF CT
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21087-1253
Practice Address - Country:US
Practice Address - Phone:251-213-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAG05200015363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner