Provider Demographics
NPI:1902283161
Name:GUINOTTE, STEPHANIE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:GUINOTTE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:GUINOTTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:3118 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-2200
Mailing Address - Country:US
Mailing Address - Phone:785-760-0906
Mailing Address - Fax:
Practice Address - Street 1:900 E LOGAN ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-2056
Practice Address - Country:US
Practice Address - Phone:785-242-2067
Practice Address - Fax:785-242-2068
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5345772071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily