Gwen A Guegold, F.N.P.

Individual provider Active NPI Family Nurse Practitioner · Englewood, TN

NPI 1104864602 · NPPES record last updated Jan 10, 2014

Key facts

NPI
1104864602
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
APN5518 (TN)
Practice address
3360 Highway 411 N
Englewood, TN 37329-5276
Phone
(423) 887-5131
Fax
(423) 887-5917
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN49800TNMDRegistered Nurse
APN5518TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Health Systems Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5518 TN
Family Nurse Practitioner 363LF0000X APN5518 TN Yes
Registered Nurse 163W00000X RN49800 TN

Addresses

Primary practice location

3360 Highway 411 N
Englewood, TN 37329-5276

Mailing address

6350 W Andrew Johnson Hwy
Department 100
Talbott, TN 37877-8605
Phone (800) 355-3565

Other identifiers

IdentifierTypeStateIssuer
3072348OtherTNBLUE CROSS BLUE SHIELD #
3344283MedicaidTN

Other providers in Englewood, TN

All providers in Englewood, TN · Family Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.