Individual
GWEN A GUEGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
3360 HIGHWAY 411 N, ENGLEWOOD, TN 37329-5276
(423) 887-5131
(423) 887-5917
Mailing address
6350 W ANDREW JOHNSON HWY, DEPARTMENT 100, TALBOTT, TN 37877-8605
(800) 355-3565
(423) 714-2355
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN49800
TN
363L00000X
Nurse Practitioner
5518
TN
363LF0000X
Family Nurse Practitioner
Primary
APN5518
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3072348
BLUE CROSS BLUE SHIELD #
TN
05
—
3344283
—
TN
Enumeration date
06/04/2006
Last updated
01/10/2014
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