Physician Compare National (NPI:1164989059)

HEALTHCARE PROVIDER: ALIVIA FONTENOT GUILLORY FNP-C

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1164989059
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082954375
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190325000454
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FONTENOT
	Individual professional last name
Provider First Name	ALIVIA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2018
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	421 N AVE F
	Group Practice or individual's line 1 address
City	CROWLEY
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	705265044
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	190017
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OPELOUSAS GENERAL HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	190167
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MERCY REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	190044
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ACADIA GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	191319
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ACADIA ST LANDRY
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	191302
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	ST MARTIN HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1164989059)

HEALTHCARE PROVIDER: ALIVIA FONTENOT GUILLORY FNP-C

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information