Provider Demographics
NPI:1952115412
Name:PROSPER GUZMAN, CARMEN GISELLE (NURSE MSN)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:GISELLE
Last Name:PROSPER GUZMAN
Suffix:
Gender:F
Credentials:NURSE MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 5824
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-8801
Mailing Address - Country:US
Mailing Address - Phone:787-400-3034
Mailing Address - Fax:
Practice Address - Street 1:BO PALMAREJO, CARR 164
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783
Practice Address - Country:US
Practice Address - Phone:787-400-3034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5511-E174400000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty