Provider Demographics
NPI:1386140838
Name:GUESS, KATTURAH
Entity type:Individual
Prefix:
First Name:KATTURAH
Middle Name:
Last Name:GUESS
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 1:426 AUGUSTINE ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613-1312
Mailing Address - Country:US
Mailing Address - Phone:585-743-5424
Mailing Address - Fax:
Practice Address - Street 1:426 AUGUSTINE ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-1312
Practice Address - Country:US
Practice Address - Phone:585-743-5424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331095164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse