Healthcare Provider Details

I. General information

NPI: 1356585533
Provider Name (Legal Business Name): CHRISSY GUIDRY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 08/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 TULANE AVE
NEW ORLEANS LA
70112-2632
US

IV. Provider business mailing address

1430 TULANE AVE
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 150-498-8526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number20A13824
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number305233
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: