Provider Demographics
NPI:1639720543
Name:GUIDRY, KATHRYN FERGUSON
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:FERGUSON
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 1:128 CLAREMONT CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7300
Mailing Address - Country:US
Mailing Address - Phone:337-207-3135
Mailing Address - Fax:
Practice Address - Street 1:128 CLAREMONT CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7300
Practice Address - Country:US
Practice Address - Phone:337-207-3135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider