Provider Demographics
NPI:1427654649
Name:GUINN, ALISHA L
Entity type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:L
Last Name:GUINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:LYNNE
Other - Last Name:CHILDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4271 UNROE AVE
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1031
Mailing Address - Country:US
Mailing Address - Phone:614-218-9920
Mailing Address - Fax:
Practice Address - Street 1:1019 E 18TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2443
Practice Address - Country:US
Practice Address - Phone:614-218-9920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2076775Medicaid
OH2561239OtherDODD