Mary Lou Guillot, CRNA,FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP01331 Issued in LA

Practice address

11990 Jackson St
Clinton, LA 70722-3210

Phone

(225) 683-5292

Fax

(225) 683-3411

NPI assigned

Dec 13, 2005

Last updated

Mar 27, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DRS Burleigh, Dupleix and Rees

  dba Lafayette Anesthesia Services

  • Anesthesiology Physician
  • Lafayette, LA
  • NPI 1659368694
  NPD (past)
• Jorge J Bravo MD a Professional Corporation

  • Anesthesiology Physician
  • Thibodaux, LA
  • NPI 1801804646
  NPD (past)
• Anesthesia Associates of Athens, Inc

  • Anesthesiology Physician
  • Athens, OH
  • NPI 1801156344

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1326023201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707220395",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11990 JACKSON ST",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707223210",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLOT",
        "first_name": "MARY LOU",
        "name_prefix": "Mrs.",
        "credential": "CRNA,FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP01331",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "CRNA00994",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "1395994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA/FNP",
            "identifier": "08309838",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08309838",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1189405",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP-C",
            "identifier": "1445894",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA",
            "identifier": "1395994",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Nursing Home Inc (Grace Health and Rehabilitation Center)
• Traci Gremillion, MSW, LCSW
• Monica S Grimes, LMSW
• Kelly Elizabeth Guedry, D.D.S.
• Stacie B. Guillory, LCSW
• Cynthia P Hall, NP
• Iesha Marie Harris
• Frances R Havard, RN
• Eric Wallace Hayes, DDS
• Sondra Denise Hayes, LPC, LMFT, LAC

• Family Nurse Practitioner in Clinton, LA
• Providers in Clinton, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.