Provider Demographics
NPI:1114232386
Name:GUILLOU, ISABELLE (APRN-FPA, CNM, IBCLC)
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:
Last Name:GUILLOU
Suffix:
Gender:
Credentials:APRN-FPA, CNM, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4202 E BROADWAY RD UNIT 87
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1062
Mailing Address - Country:US
Mailing Address - Phone:630-209-3250
Mailing Address - Fax:480-558-4384
Practice Address - Street 1:4202 E BROADWAY RD UNIT 87
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1062
Practice Address - Country:US
Practice Address - Phone:630-209-3250
Practice Address - Fax:480-558-4384
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL377-000306367A00000X
AZ290623367A00000X
IL277-300309367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty