Provider Demographics
NPI:1457027450
Name:GUILLORY, KAYLEIGH PAIGE (RN)
Entity Type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:PAIGE
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 1:322 BROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WOODWORTH
Mailing Address - State:LA
Mailing Address - Zip Code:71485-7905
Mailing Address - Country:US
Mailing Address - Phone:318-623-2553
Mailing Address - Fax:
Practice Address - Street 1:5604 COLISEUM BLVD STE A
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3993
Practice Address - Country:US
Practice Address - Phone:318-487-5282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201818163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse