Provider Demographics
NPI:1689714685
Name:NICHOLSON-GUIDRY, CYNTHIA ELIZABETH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:NICHOLSON-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 1:5724 WILLOW WOOD LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-2661
Mailing Address - Country:US
Mailing Address - Phone:972-248-9227
Mailing Address - Fax:866-239-7695
Practice Address - Street 1:5068 W PLANO PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-248-9227
Practice Address - Fax:866-239-7695
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253087363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87N196Medicare ID - Type Unspecified
TXP19545Medicare UPIN