Provider Demographics
NPI:1700316601
Name:GUILFOYLE, CARRIE ALICE (ANP-C)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ALICE
Last Name:GUILFOYLE
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BRANSCOMB ROAD
Mailing Address - Street 2:LONG VALLEY HEALTH CENTER
Mailing Address - City:LAYTONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95454
Mailing Address - Country:US
Mailing Address - Phone:707-984-6131
Mailing Address - Fax:
Practice Address - Street 1:50 BRANSCOMB ROAD
Practice Address - Street 2:
Practice Address - City:LAYTONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95454
Practice Address - Country:US
Practice Address - Phone:707-984-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAG02170177363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care