Provider Demographics
NPI:1386350601
Name:GUY, ALISON JANE (RN)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:JANE
Last Name:GUY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ALISON
Other - Middle Name:JANE
Other - Last Name:CLARKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:241 MERRILL RD
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:NY
Mailing Address - Zip Code:13077-9745
Mailing Address - Country:US
Mailing Address - Phone:315-663-8435
Mailing Address - Fax:
Practice Address - Street 1:241 MERRILL RD
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:NY
Practice Address - Zip Code:13077-9745
Practice Address - Country:US
Practice Address - Phone:315-663-8435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY703087-01163W00000X
NY703087163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYENGLAND1616Medicaid