Individual
MRS. MARY LOU GUILLOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA,FNP-C
Contact information
Practice address
11990 JACKSON ST, CLINTON, LA 70722-3210
(225) 683-5292
(225) 683-3411
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-3411
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP01331
LA
367500000X
Certified Registered Nurse Anesthetist
1395994
LA
367500000X
Certified Registered Nurse Anesthetist
CRNA00994
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08309838
CRNA/FNP
MS
05
—
08309838
—
MS
05
—
1189405
—
LA
01
—
1395994
CRNA
LA
01
—
1445894
FNP-C
LA
Enumeration date
12/13/2005
Last updated
03/27/2019
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