Individual
ELLEN MCANDREWS GUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
841 PRUDENTIAL DR, UFJAX - PEDS MULTISPECIALTY CLINIC, JACKSONVILLE, FL 32207-8329
(904) 633-0780
(904) 633-0781
Mailing address
PO BOX 44008, UFJAX - PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9297852
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135827A
—
GA
05
—
009122100
—
FL
Enumeration date
06/13/2013
Last updated
02/03/2020
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