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General NPI Number Information
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NPI Number | 1104865336
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Entity Type | Individual
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Provider Name | SHELLY KAYE GUILLORY APRN C-FNP
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Gender | Female
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 277 US 171 #10
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City | LAKE CHARLES
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State | LA
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Zip | 70611
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Country | US
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Telephone | 337-217-7762
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Fax |
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Provider Business Mailing Address
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Address Line | 612 MILL CREEK ACRES
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City | BROOKELAND
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State | TX
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Zip | 75931
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Country | US
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Telephone | 337-515-2971
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP04498
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License Number State | LA
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