Individual
MRS. JACQUELINE M. GUETIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7430 JEFFERSON BLVD, SUITE 100, LOUISVILLE, KY 40219-6159
(502) 969-0975
(502) 969-0081
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3004541
KY
363L00000X
Nurse Practitioner
4541P
KY
363LX0106X
Occupational Health Nurse Practitioner
71001870C
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71000857
—
KY
Enumeration date
05/29/2007
Last updated
11/23/2018
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