Provider Demographics
NPI:1225813132
Name:GUILLORY, ALAINA LEE (APRN)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:LEE
Last Name:GUILLORY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:LEE
Other - Last Name:SIMANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3315 KETHLEY RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-9638
Mailing Address - Country:US
Mailing Address - Phone:405-273-5801
Mailing Address - Fax:405-273-5172
Practice Address - Street 1:3315 KETHLEY RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-9638
Practice Address - Country:US
Practice Address - Phone:405-273-5801
Practice Address - Fax:405-273-5172
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK213191363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty