Provider Demographics
NPI:1306279294
Name:GUILBEAU, JANIS RICHARD (FNP)
Entity type:Individual
Prefix:DR
First Name:JANIS
Middle Name:RICHARD
Last Name:GUILBEAU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 KRISTEN LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6366
Mailing Address - Country:US
Mailing Address - Phone:337-988-4462
Mailing Address - Fax:
Practice Address - Street 1:123 KRISTEN LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6366
Practice Address - Country:US
Practice Address - Phone:337-988-4462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA005468363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily