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NPI Code Detail

MEDICARE: SHAWANNA MARIE GUILLORY FNP

MEDICARE: SHAWANNA MARIE GUILLORY FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP07537LA

General Provider Information

NPI Number : 1013344274
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWANNA MARIE GUILLORY FNP
Provider Business Mailing Address
First Line : PO BOX 2651
Second Line :
City : OPELOUSAS
State : LA
Zip : 70571-2651
Country : US
Telephone Number : 337-384-9219
Fax Number :
Provider Business Practice Location Address
First Line : 811 ALBERTSON PKWY STE G
Second Line :
City : BROUSSARD
State : LA
Zip : 70518-5256
Country : US
Telephone Number : 337-290-8520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2013
Last Update Date : 01/03/2022

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Directions to “ SHAWANNA MARIE GUILLORY FNP” Practice Location

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