Basic Information
| Provider Information | |||||||||
| NPI: | 1427297266 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGUIRE | ||||||||
| FirstName: | JAIMEE | ||||||||
| MiddleName: | ALLISEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DNP, RN, NP-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GIVENS | ||||||||
| OtherFirstName: | JAIMEE | ||||||||
| OtherMiddleName: | ALLISEN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | P.O. BOX 290 | ||||||||
| Address2: | 210 1ST STREET | ||||||||
| City: | WANBLEE | ||||||||
| State: | SD | ||||||||
| PostalCode: | 57577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6054626155 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 210 1ST STREET | ||||||||
| Address2: | |||||||||
| City: | WANBLEE | ||||||||
| State: | SD | ||||||||
| PostalCode: | 57577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6054626155 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2009 | ||||||||
| LastUpdateDate: | 08/23/2016 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2006002520 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.