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General NPI Number Information
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NPI Number | 1699186130
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Entity Type | Individual
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Provider Name | ANN-THERESE GUILLORY RN
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Gender | Female
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 7329 BALMER ST BLDG 546
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City | HILL AFB
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State | UT
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Zip | 84056-5012
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Country | US
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Telephone | 801-777-0634
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Fax |
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Provider Business Mailing Address
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Address Line | 1217 E 2675 N
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City | LAYTON
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State | UT
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Zip | 84040-8521
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Country | US
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Telephone | 504-439-4428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | 60072383102
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License Number State | UT
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