Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 0101230231 | VA |
NPI | 1942230040 |
---|---|
Provider Name | Nathan L. Guerette |
First Address | North Chesterfield, VA 23235-4730 |
Second Address | North Chesterfield, VA 23235-4730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 10/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H65924 | (02) | VA |