Provider Demographics
NPI:1366744674
Name:GUENETTE, TERRESA MARIE (CNA 2)
Entity type:Individual
Prefix:MRS
First Name:TERRESA
Middle Name:MARIE
Last Name:GUENETTE
Suffix:
Gender:F
Credentials:CNA 2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 SUNSET CT
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8417
Mailing Address - Country:US
Mailing Address - Phone:828-256-9815
Mailing Address - Fax:
Practice Address - Street 1:1147 SUNSET CT
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8417
Practice Address - Country:US
Practice Address - Phone:828-256-9815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC59526376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide