Provider Demographics
NPI:1871813840
Name:GUSE, MEGAN NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:GUSE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:245 S DOBSON RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6577
Mailing Address - Country:US
Mailing Address - Phone:480-895-5870
Mailing Address - Fax:480-895-0573
Practice Address - Street 1:245 S DOBSON RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6577
Practice Address - Country:US
Practice Address - Phone:480-895-5870
Practice Address - Fax:480-895-0573
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ4634363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical