Provider Demographics
NPI:1174517080
Name:MCGUYER, AUDREY PRUESSNER (CNM)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:PRUESSNER
Last Name:MCGUYER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 FANNIN ST
Mailing Address - Street 2:STE 1050
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1920
Mailing Address - Country:US
Mailing Address - Phone:713-795-1004
Mailing Address - Fax:713-796-9485
Practice Address - Street 1:7400 FANNIN ST
Practice Address - Street 2:STE 1050
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1920
Practice Address - Country:US
Practice Address - Phone:713-795-1004
Practice Address - Fax:713-796-9485
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX568170363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner