Provider Demographics
NPI:1053030015
Name:GUY, JAMIE D (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:D
Last Name:GUY
Suffix:
Gender:M
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:407-279-1004
Mailing Address - Fax:
Practice Address - Street 1:4600 TOUCHTON RD E STE 150
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-8299
Practice Address - Country:US
Practice Address - Phone:407-279-1004
Practice Address - Fax:407-279-1004
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9398628163W00000X
AZ309763363LP0808X
FLAPRN11022656363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse