Provider Demographics
NPI:1144460379
Name:GUERRERO, PHEBE REYNOSO (CERT NURSING ASST)
Entity type:Individual
Prefix:MS
First Name:PHEBE
Middle Name:REYNOSO
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:CERT NURSING ASST
Other - Prefix:MS
Other - First Name:PHEBE
Other - Middle Name:OMAYAO
Other - Last Name:REYNOSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6490 WOLF RUN SHOALS RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-1742
Mailing Address - Country:US
Mailing Address - Phone:703-250-1944
Mailing Address - Fax:
Practice Address - Street 1:6490 WOLF RUN SHOALS RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX STATION
Practice Address - State:VA
Practice Address - Zip Code:22039-1742
Practice Address - Country:US
Practice Address - Phone:703-250-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion