MEDICARE: DYSHUNTA M GUY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	197796	TN

General Provider Information

NPI Number	:	1932983194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DYSHUNTA M GUY

Provider Business Mailing Address
First Line	:	5510 GWENDOLYN DR APT 201
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38125-0848
Country	:	US
Telephone Number	:	901-517-2431
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 S HOUSTON LEVEE RD
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-1344
Country	:	US
Telephone Number	:	901-779-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2023
Last Update Date	:	08/21/2023

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Directions to “ DYSHUNTA M GUY ” Practice Location

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