Provider Demographics
NPI:1063924371
Name:GUY, CHRISTINA KAY
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:KAY
Last Name:GUY
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:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL HILL
Mailing Address - State:IL
Mailing Address - Zip Code:62916-0305
Mailing Address - Country:US
Mailing Address - Phone:618-426-1111
Mailing Address - Fax:618-426-3988
Practice Address - Street 1:16343 HIGHWAY 4
Practice Address - Street 2:
Practice Address - City:CAMPBELL HILL
Practice Address - State:IL
Practice Address - Zip Code:62916-2105
Practice Address - Country:US
Practice Address - Phone:618-426-1111
Practice Address - Fax:618-426-3988
Is Sole Proprietor?:No
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.322697163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse