Provider Demographics
NPI:1164923611
Name:GUILLORY, NONYE GERDING
Entity Type:Individual
Prefix:
First Name:NONYE
Middle Name:GERDING
Last Name:GUILLORY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13716 W RIM DR APT 613
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-7417
Mailing Address - Country:US
Mailing Address - Phone:469-432-7401
Mailing Address - Fax:
Practice Address - Street 1:631 GLENHILL LN
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75077-2828
Practice Address - Country:US
Practice Address - Phone:972-839-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX323691364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34100892OtherDRIVERS LICENSE NUMBER
34100892OtherDRIVERS LICENSE NUMBER