Provider Demographics
NPI:1528615028
Name:GUZMAN, WENDY JEAN (RN)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:JEAN
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:JEAN
Other - Last Name:ORR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2060 CENTRE POINTE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55120-1271
Mailing Address - Country:US
Mailing Address - Phone:651-774-0011
Mailing Address - Fax:612-870-3789
Practice Address - Street 1:245 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3467
Practice Address - Country:US
Practice Address - Phone:612-872-2071
Practice Address - Fax:612-870-3789
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR167812-7163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse