Basic Information
| Provider Information | |||||||||
| NPI: | 1508385808 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUZMAN | ||||||||
| FirstName: | ESTER | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | MSN, APRN, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1610 E 23 1/2 ST | ||||||||
| Address2: | |||||||||
| City: | MISSION | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785747942 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3804 S JACKSON RD STE 2 | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785396683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562963021 | ||||||||
| FaxNumber: | 9562963020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2017 | ||||||||
| LastUpdateDate: | 10/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 781364 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 378259101 | 05 | TX | MEDICAID |