Provider Demographics
NPI:1992793814
Name:GUERRA, LAURA (FNP)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:GUERRA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 PLUNKETT RD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:95524-9701
Mailing Address - Country:US
Mailing Address - Phone:707-826-2567
Mailing Address - Fax:
Practice Address - Street 1:1001 LYCOMING AVE
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-9308
Practice Address - Country:US
Practice Address - Phone:707-839-6115
Practice Address - Fax:707-839-6178
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily