Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gudalia Fajardo

Individual provider Family Nurse Practitioner · NPI 1083019012

Gudalia Fajardo is a Nurse Practitioner in Port Huron, Michigan. Qualified in 2014, 12 years ago. Practices with St Clair Specialty Physicians PC, a 36-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
12
Licensed in
MI
In the registry since
2014
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2603 Electric Ave Ste 1
Port Huron, MI 48060-6588
Phone: (810) 987-5252
Fax: (810) 987-2120
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704267837 (MI)

Record details

NPI number1083019012
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 4, 2014
Last updated in NPPESFebruary 17, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice St Clair Specialty Physicians Pc — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Port Huron