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General NPI Number Information
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NPI Number | 1750686762
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Entity Type | Individual
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Provider Name | ANGELA MARIE GUIDRY PH.D, APRN, CPNP
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Gender | Female
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Dates
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Enumeration Date | 01/21/2011
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1572 HIGHWAY 85 N STE 203
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7726
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Country | US
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Telephone | 678-457-1229
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Fax | 320-210-2011
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Provider Business Mailing Address
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Address Line | 70 HEATHROW DR
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City | RIVERDALE
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State | GA
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Zip | 30274-2763
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Country | US
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Telephone | 678-457-1229
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN091759
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License Number State | GA
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