Provider Demographics
NPI:1003599309
Name:GUIDRY, MICHELLE LYNNE (APRFNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNNE
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:APRFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41800 W 11 MILE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1818
Mailing Address - Country:US
Mailing Address - Phone:833-578-2763
Mailing Address - Fax:248-282-5044
Practice Address - Street 1:LOCUM TENENS POSITIONS
Practice Address - Street 2:123 W. ELM ST.
Practice Address - City:SILVER LAKE
Practice Address - State:WI
Practice Address - Zip Code:53170
Practice Address - Country:US
Practice Address - Phone:262-891-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2022067755363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily