Individual
CODIE JESSICA LEE GUIDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
277 N HIGHWAY 171 STE 10, LAKE CHARLES, LA 70611-5374
(337) 217-7762
Mailing address
277 N HIGHWAY 171 STE 10, LAKE CHARLES, LA 70611-5374
(337) 217-7762
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN128288
LA
363LF0000X
Family Nurse Practitioner
Primary
AP08635
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2409891
—
LA
Enumeration date
01/27/2016
Last updated
10/18/2019
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