Provider Demographics
NPI:1962196121
Name:GUEVARA RAMIREZ, YENI LINA
Entity type:Individual
Prefix:
First Name:YENI
Middle Name:LINA
Last Name:GUEVARA RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 SHEPHERDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-5042
Mailing Address - Country:US
Mailing Address - Phone:502-202-3426
Mailing Address - Fax:
Practice Address - Street 1:8910 SHEPHERDSVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-5042
Practice Address - Country:US
Practice Address - Phone:502-202-3426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4005551363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily