Provider Demographics
NPI:1053673186
Name:GUIDRY, FELICIA CHARLOTTE (RN)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:CHARLOTTE
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 POLK ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4154
Mailing Address - Country:US
Mailing Address - Phone:985-857-3601
Mailing Address - Fax:985-857-3607
Practice Address - Street 1:600 POLK ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4154
Practice Address - Country:US
Practice Address - Phone:985-857-3601
Practice Address - Fax:985-857-3607
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN049822163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health