Provider Demographics
NPI:1417473414
Name:GUYETTE, JILL CHRISTINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:CHRISTINE
Last Name:GUYETTE
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 1:6 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PAINTED POST
Mailing Address - State:NY
Mailing Address - Zip Code:14870-9315
Mailing Address - Country:US
Mailing Address - Phone:607-426-9818
Mailing Address - Fax:
Practice Address - Street 1:64 E LAMOKA AVE
Practice Address - Street 2:
Practice Address - City:SAVONA
Practice Address - State:NY
Practice Address - Zip Code:14879-9714
Practice Address - Country:US
Practice Address - Phone:607-527-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY535874163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool