Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 7440 | CA |
NPI | 1053399030 |
---|---|
Provider Name | Nanette Gay Guadiana |
First Address | Fresno, CA 93726-4301 |
Second Address | Fresno, CA 93701-2125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2006 |
Last Update Date | 22/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
404832 | REGISTERED NURSE LIC (01) | CA |
7440 | NURSE FURNISHING LIC (01) | CA |