Provider Demographics
NPI:1063568475
Name:GUYETTE, JULIE A (FNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:GUYETTE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6081 N 1ST ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5466
Mailing Address - Country:US
Mailing Address - Phone:559-436-5265
Mailing Address - Fax:559-436-4958
Practice Address - Street 1:6081 N 1ST ST
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5466
Practice Address - Country:US
Practice Address - Phone:559-436-5265
Practice Address - Fax:559-436-4958
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5123363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ15933ZMedicare Oscar/Certification