Provider Demographics
NPI:1679028260
Name:GUIDRY, RACHELLE R (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:RACHELLE
Middle Name:R
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 HIGHWAY 3162
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345-3582
Mailing Address - Country:US
Mailing Address - Phone:985-632-1820
Mailing Address - Fax:985-632-1824
Practice Address - Street 1:314 HIGHWAY 3162
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-3582
Practice Address - Country:US
Practice Address - Phone:985-632-1820
Practice Address - Fax:985-632-1824
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08806363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2427873Medicaid