Provider Demographics
NPI:1548285745
Name:GUIDA, DIANE ANTOINETTE (RN-C)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:ANTOINETTE
Last Name:GUIDA
Suffix:
Gender:F
Credentials:RN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 NUN ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-5019
Mailing Address - Country:US
Mailing Address - Phone:910-254-9505
Mailing Address - Fax:
Practice Address - Street 1:2714 MARKET ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1218
Practice Address - Country:US
Practice Address - Phone:910-254-9898
Practice Address - Fax:910-254-9818
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC194500OtherRN LICENSE
NC136148OtherNP REGISTRATION-MED. BD.