Provider Demographics
NPI:1811160724
Name:GUITH, BONNIE (CNP)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:
Last Name:GUITH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2284 S BALLENGER HWY
Mailing Address - Street 2:SUITE H
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-3446
Mailing Address - Country:US
Mailing Address - Phone:810-233-5211
Mailing Address - Fax:810-233-5740
Practice Address - Street 1:2284 S BALLENGER HWY
Practice Address - Street 2:SUITE H
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-3446
Practice Address - Country:US
Practice Address - Phone:810-233-5211
Practice Address - Fax:810-233-5740
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704118726363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner