Provider Demographics
NPI:1477815462
Name:GUILLORY, JAMIE (RN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:GUILLORY
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 1:308 W BLOCH ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-5214
Mailing Address - Country:US
Mailing Address - Phone:337-948-0220
Mailing Address - Fax:337-948-0324
Practice Address - Street 1:308 W BLOCH ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-5214
Practice Address - Country:US
Practice Address - Phone:337-948-0220
Practice Address - Fax:337-948-0324
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN116088163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health