Active NPI
Avilynn Pwyll
- General Practice Registered Nurse
- Guerneville, CA
National Provider Identifier
1003561671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- 359686
- Practice address
- 17227 Old Monte Rio Rd
Guerneville, CA 95446-9016 - Phone
- (707) 867-6866
- NPI assigned
- Feb 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 359686 | CA | Primary |
Addresses
Primary practice location
17227 Old Monte Rio Rd
Guerneville, CA 95446-9016
Mailing address
PO Box 2992
Guerneville, CA 95446-2992
Phone (707) 867-6866
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 359686 | Other | CA | CALIFORNIA BOARD OF REGISTERED NURSING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 359686 | CA | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644710400000",
"number": "1003561671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2992",
"city": "GUERNEVILLE",
"state": "CA",
"postal_code": "954462992",
"telephone_number": "707-867-6866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17227 OLD MONTE RIO RD",
"city": "GUERNEVILLE",
"state": "CA",
"postal_code": "954469016",
"telephone_number": "707-867-6866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PWYLL",
"first_name": "AVILYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-13",
"last_updated": "2022-02-13",
"certification_date": "2022-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "CA",
"license": "359686",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF REGISTERED NURSING",
"identifier": "359686",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Guerneville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.