Provider Demographics
NPI:1154831139
Name:GUIDRY, STACEY ANN GILLIAN (FNP)
Entity Type:Individual
Prefix:
First Name:STACEY ANN
Middle Name:GILLIAN
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2505
Mailing Address - Country:US
Mailing Address - Phone:214-293-9269
Mailing Address - Fax:
Practice Address - Street 1:4412 OXBOW DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-9148
Practice Address - Country:US
Practice Address - Phone:214-293-9269
Practice Address - Fax:214-293-9269
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134384163WR0400X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation