Provider Demographics
NPI:1295595189
Name:GUADAGNOLI, KAYLEIGH LAUREN (NP)
Entity type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:LAUREN
Last Name:GUADAGNOLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 CHINOOK LN
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1850
Mailing Address - Country:US
Mailing Address - Phone:719-564-9400
Mailing Address - Fax:
Practice Address - Street 1:1080 CHINOOK LN
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1850
Practice Address - Country:US
Practice Address - Phone:719-564-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0999597363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner