Provider Demographics
NPI:1922761410
Name:GUIDROZ, BRENDA JULIEN
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:JULIEN
Last Name:GUIDROZ
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 1:2341 LITCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2220
Mailing Address - Country:US
Mailing Address - Phone:504-249-3924
Mailing Address - Fax:
Practice Address - Street 1:2100 WOODMERE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2294
Practice Address - Country:US
Practice Address - Phone:504-249-3924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide