Sara Mundo, PA
Physician Assistant in Lexington, KY. Individual provider (NPI-1).
NPI number1194458745
StatusActive
Last updated in NPPESJan 10, 2024
Details
- NPI
- 1194458745
- Entity type
- Individual (NPI-1)
- Name
- Sara Mundo
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 1, 2022
- Certification date
- Jan 10, 2024
- Last updated
- Jan 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA3310 | KY | Yes |
| 363A00000X | Physician Assistant | – | – | |
| 363A00000X | Physician Assistant | TC014 | KY | |
| 363AM0700X | Physician Assistant, Medical | PA3310 | KY | |
| 363AM0700X | Physician Assistant, Medical | TC014 | KY | |
| 363AS0400X | Physician Assistant, Surgical | PA3310 | KY | |
| 363AS0400X | Physician Assistant, Surgical | TC014 | KY |
Practice location
1000 S LimestoneLexington, KY 40536-5519
Phone 859-323-5901 · Fax 859-323-3040
Mailing address
1000 S LimestoneLexington, KY 40536-0001
Phone 859-323-5901 · Fax 859-323-3040
Other practice locations
650 E Parkway S
Memphis, TN 38104-5519
Memphis, TN 38104-5519
Phone 970-219-4266
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