Provider Demographics
NPI:1932650124
Name:GUEST, KATHLEEN T (APRN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:T
Last Name:GUEST
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:STURZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-361-1222
Mailing Address - Fax:502-368-1258
Practice Address - Street 1:1900 BLUEGRASS AVE STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1183
Practice Address - Country:US
Practice Address - Phone:502-361-1222
Practice Address - Fax:502-368-1258
Is Sole Proprietor?:No
Enumeration Date:2016-10-22
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010898363LF0000X, 363LF0000X
KY1135949163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300055441Medicaid
KY7100450680Medicaid