| Doctor Name: | MRS. LATRIESE GUYTON |
| NPI Number: | 1184843872 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | |
| Business Practice Address: | 12723 Honore St Blue Island, IL - 604062205 |
| Business Phone Number: | 7084895798 |
| Business Fax Number: | |
| Mailing Address: | 12723 Honore St, BLUE ISLAND |
| State: | IL |
| Postal Code: | 604062205 |
| Phone Number: | 7084895798 |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WN1003X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Nutrition Support |
| Taxonomy Definition: | |