Provider Demographics
NPI:1417771346
Name:GUTHMILLER, MONICA RAE (LPN)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:RAE
Last Name:GUTHMILLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3202 COLBY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4324
Mailing Address - Country:US
Mailing Address - Phone:425-526-4174
Mailing Address - Fax:425-526-5842
Practice Address - Street 1:3202 COLBY AVE STE A
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4324
Practice Address - Country:US
Practice Address - Phone:425-526-4174
Practice Address - Fax:425-526-5842
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00040077164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse