Provider Demographics
NPI:1184060105
Name:GUIDO, JESSICA LYNN (FNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:GUIDO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:YOAKAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1740 NW GOETZ ST
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-1613
Mailing Address - Country:US
Mailing Address - Phone:541-672-4885
Mailing Address - Fax:541-672-4541
Practice Address - Street 1:1740 NW GOETZ ST
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1613
Practice Address - Country:US
Practice Address - Phone:541-672-4885
Practice Address - Fax:541-672-4541
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201350094NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily