Healthcare Provider Details

I. General information

NPI: 1912822073
Provider Name (Legal Business Name): SHELLEY RENEE GUILBEAU APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E SAINT MARY BLVD
LAFAYETTE LA
70503-2040
US

IV. Provider business mailing address

400 E SAINT MARY BLVD
LAFAYETTE LA
70503-2040
US

V. Phone/Fax

Practice location:
  • Phone: 337-482-6682
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number217164
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: