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Individual

MALLORY JADE GUAGENTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3399 TATES CREEK RD STE 230, LEXINGTON, KY 40502-7404
(859) 523-5893
Mailing address
4016 PARKER MDWS, LEXINGTON, KY 40515-4825
(270) 589-7827

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3013325
KY

Other

Enumeration date
04/24/2019
Last updated
04/24/2019
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