Provider Demographics
NPI:1679872998
Name:GUYTON, NICOLE SHERI
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:SHERI
Last Name:GUYTON
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 1:18250 MIDDLEBELT RD #101
Mailing Address - Street 2:BLESSED DAYZ ADULT DAY CARE
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-5004
Mailing Address - Country:US
Mailing Address - Phone:313-505-6525
Mailing Address - Fax:313-304-3404
Practice Address - Street 1:18250 MIDDLEBELT RD
Practice Address - Street 2:#101
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-5004
Practice Address - Country:US
Practice Address - Phone:313-505-6525
Practice Address - Fax:313-304-3404
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker