Provider Demographics
NPI:1154937910
Name:GUION, GREGORY (APRN)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:GUION
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 NORTH ST
Mailing Address - Street 2:STE 103
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5653
Mailing Address - Country:US
Mailing Address - Phone:860-996-1569
Mailing Address - Fax:860-257-7999
Practice Address - Street 1:72 NORTH ST
Practice Address - Street 2:STE 103
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5653
Practice Address - Country:US
Practice Address - Phone:860-996-1569
Practice Address - Fax:860-257-7999
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9182363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT9182OtherAPRN LICENSE