Provider Demographics
NPI:1902897168
Name:GUTHERY, ANN MARIE (PSY NP)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:GUTHERY
Suffix:
Gender:F
Credentials:PSY NP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:PROPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1919 E. THOMAS ROAD
Mailing Address - Street 2:AMBULATORY BUILDING, 4TH FLOOR
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:86018
Mailing Address - Country:US
Mailing Address - Phone:602-933-0990
Mailing Address - Fax:601-933-4251
Practice Address - Street 1:10000 N 31ST AVE
Practice Address - Street 2:A-105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9582
Practice Address - Country:US
Practice Address - Phone:602-843-0000
Practice Address - Fax:602-997-1305
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ064049363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health