Provider Demographics
NPI:1265209571
Name:GUELDA, LINDSAY CAROLE
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:CAROLE
Last Name:GUELDA
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 1:1614 CHICHESTER AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-1327
Mailing Address - Country:US
Mailing Address - Phone:502-552-4883
Mailing Address - Fax:
Practice Address - Street 1:1614 CHICHESTER AVE APT 2
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-1327
Practice Address - Country:US
Practice Address - Phone:502-552-4883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYG23-642-232251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization