Provider Demographics
NPI:1770313702
Name:PAEZ GUERRERO, CARLOS EDUARDO (RN)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:EDUARDO
Last Name:PAEZ GUERRERO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LIBERTY BELL DR NE
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-8070
Mailing Address - Country:US
Mailing Address - Phone:470-237-6606
Mailing Address - Fax:
Practice Address - Street 1:106 LIBERTY BELL DR NE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-8070
Practice Address - Country:US
Practice Address - Phone:470-237-6606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9664783163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse