Provider Demographics
NPI:1528428182
Name:GUY, TERESA KAY (ARNP, WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:KAY
Last Name:GUY
Suffix:
Gender:F
Credentials:ARNP, WHNP-BC
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:KAY
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:7406 FULLERTON ST
Mailing Address - Street 2:STE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-3552
Mailing Address - Country:US
Mailing Address - Phone:904-538-0440
Mailing Address - Fax:
Practice Address - Street 1:6107 KIPPS COLONY DR W
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:FL
Practice Address - Zip Code:33707-3969
Practice Address - Country:US
Practice Address - Phone:312-218-3377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9380799363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner