Provider Demographics
NPI:1316931470
Name:GUZMAN, VICTORIA MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MARIE
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-353-8375
Mailing Address - Fax:319-356-7533
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-353-8375
Practice Address - Fax:319-356-7533
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA051825363L00000X
IAF051825363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0416552Medicaid
IA18297OtherWELLMARK BCBS
S79048Medicare UPIN
IA18297OtherWELLMARK BCBS
IAP00712197Medicare PIN