Provider Demographics
NPI:1437541703
Name:GUEST, KELLY ANN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ANN
Last Name:GUEST
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-272-5064
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:189 OUTER LOOP
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-5544
Practice Address - Country:US
Practice Address - Phone:502-363-1731
Practice Address - Fax:502-364-9272
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3009237363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner