Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stephanie Dale Guajardo, CNP

Individual provider Nurse Practitioner · NPI 1649425380

Stephanie Dale Guajardo, CNP is a Nurse Practitioner in Troy, Ohio. Qualified in 2008, 18 years ago. Practices with Kettering Independent Medical Group Inc, a 700-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
18
Licensed in
OH
In the registry since
2008
Specialties on file
2
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

600 W Main St Ste 330
Troy, OH 45373-3384
Phone: (937) 429-7350
Fax: (937) 431-2623
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Women's Health Nurse Practitioner (primary) Taxonomy 363LW0102X · Licence 10124 (OH)
Nurse Practitioner Taxonomy 363L00000X · Licence COA10124NP (OH)

Record details

NPI number1649425380
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorNo
NPI enumeratedNovember 21, 2008
Last updated in NPPESMarch 8, 2021
Certification dateMarch 8, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Kettering Independent Medical Group Inc — 700 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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