Provider Demographics
NPI:1063097608
Name:GUERRA, JOANIE (NP)
Entity type:Individual
Prefix:
First Name:JOANIE
Middle Name:
Last Name:GUERRA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 NORTH MAIN, SECOND FLOOR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1204
Mailing Address - Country:US
Mailing Address - Phone:210-828-2503
Mailing Address - Fax:210-828-0590
Practice Address - Street 1:9153 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1502
Practice Address - Country:US
Practice Address - Phone:210-614-7414
Practice Address - Fax:210-616-0509
Is Sole Proprietor?:No
Enumeration Date:2021-03-15
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1027725363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health