Provider Demographics
NPI:1104384544
Name:GUY, MICHELE (RN)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:GUY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CASTLETON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-1209
Mailing Address - Country:US
Mailing Address - Phone:518-937-1756
Mailing Address - Fax:
Practice Address - Street 1:614 COOPER HILL RD
Practice Address - Street 2:
Practice Address - City:WYNANTSKILL
Practice Address - State:NY
Practice Address - Zip Code:12198-2906
Practice Address - Country:US
Practice Address - Phone:518-833-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY691373163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse