Provider Demographics
NPI:1699289165
Name:MOMS CHOICE MOBILE HEALTHCARE
Entity type:Organization
Organization Name:MOMS CHOICE MOBILE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIGNARD
Authorized Official - Suffix:
Authorized Official - Credentials:CPNP
Authorized Official - Phone:201-240-3650
Mailing Address - Street 1:4261 E UNIVERSITY DR STE 30-177
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9152
Mailing Address - Country:US
Mailing Address - Phone:201-240-3650
Mailing Address - Fax:972-805-9030
Practice Address - Street 1:1730 BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TX
Practice Address - Zip Code:75069-1222
Practice Address - Country:US
Practice Address - Phone:201-240-3650
Practice Address - Fax:972-805-9030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-20
Last Update Date:2022-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty