Provider Demographics
NPI:1962250365
Name:CUESTA GARCIA, YENDRIS LICET (FNP)
Entity type:Individual
Prefix:
First Name:YENDRIS
Middle Name:LICET
Last Name:CUESTA GARCIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 SPICEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-1023
Mailing Address - Country:US
Mailing Address - Phone:786-578-1239
Mailing Address - Fax:
Practice Address - Street 1:7926 PRESTON HWY STE 210
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-3848
Practice Address - Country:US
Practice Address - Phone:502-371-0022
Practice Address - Fax:502-394-3620
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4023866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily