Provider Demographics
NPI:1114309507
Name:GUIDRY, ANN
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:GUIDRY
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 1:8061 KENSINGTON BLVD
Mailing Address - Street 2:403
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-2273
Mailing Address - Country:US
Mailing Address - Phone:832-588-6848
Mailing Address - Fax:
Practice Address - Street 1:8061 KENSINGTON BLVD
Practice Address - Street 2:403
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-2273
Practice Address - Country:US
Practice Address - Phone:832-588-6848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other