Healthcare Provider Details

I. General information

NPI: 1679872998
Provider Name (Legal Business Name): MS. NICOLE SHERI GUYTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 03/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18250 MIDDLEBELT RD #101
LIVONIA MI
48152-5004
US

IV. Provider business mailing address

18250 MIDDLEBELT RD #101 BLESSED DAYZ ADULT DAY CARE
LIVONIA MI
48152-5004
US

V. Phone/Fax

Practice location:
  • Phone: 313-505-6525
  • Fax: 313-304-3404
Mailing address:
  • Phone: 313-505-6525
  • Fax: 313-304-3404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: