ANDREA HALE STUCKER (NPI# 1578821393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578821393 |
| Entity Type | Individual |
| Full Name | ANDREA HALE STUCKER |
| Credential | P.A.-C |
| Practice Address |
3615 E John Rowan Blvd Ste 203 Bardstown KY 40004-3265 |
| Mailing Address |
5200 Commerce Crossings Dr Louisville KY 40229-2182 |
| Practice Telephone | 5023376815 |
| Practice Fax Number | 5023571682 |
| Mailing Telephone | 5022534900 |
| Mailing Fax Number | 5024895751 |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2020-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1721 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MEDICAL LICENSE | PA1721 | 01 |
| KY | 7100212110 | 05 |
| Street Address |
3615 E JOHN ROWAN BLVD STE 203 |
| City | BARDSTOWN |
| State | KY |
| Zip Code | 40004-3265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013014133 | Sanjiv Mehta | Legal Medicine | 3615 E John Rowan Blvd Ste 203, Bardstown, KY 40004-3265 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710590880 | Flaget Healthcare, Inc | Clinic/Center | 4359 Shepherdsville Road, Ste 255, Bardstown, KY 40004 | 2020-08-28 |
| 1902421043 | Astra Recovery Centers, LLC | Substance Abuse Rehabilitation Facility | 202 Downs Lane, Bardstown, KY 40004 | 2020-06-15 |
| 1285296194 | Hardin Memorial Hospital | Pharmacy | 3615 E John Rowan Blvd, Bardstown, KY 40004 | 2019-07-01 |
| 1376024919 | Flaget Healthcare Inc | Clinic/Center | 110 N. Salem Drive, Bardstown, KY 40004 | 2018-08-22 |
| 1730697517 | Shannon Michelle Woods | Nurse Practitioner | 1095 Morton Ave, Bardstown, KY 40004 | 2018-01-16 |
| 1477922490 | Kristi Ballard | Counselor | 1000 E John Rowan Blvd Ste 107, Bardstown, KY 40004 | 2015-09-21 |
| 1659705309 | Patricia Hall | Speech-Language Pathologist | 310 South 6th Street, Bardstown, KY 40004 | 2013-08-29 |
| 1629314885 | Saint Joseph-anc Home Care Services, LLC | Hospice Care, Community Based | 711 Mcdowell Blvd, Bardstown, KY 40004 | 2012-12-17 |
| 1780920058 | Stars and Stripes Medical LLC | Durable Medical Equipment & Medical Supplies | 301 W. Stephen Foster Ave, Suite B., Bardstown, KY 40004 | 2012-12-14 |
| 1366790230 | Lynda Onyinyechi Uzonwune | Pharmacist | 202 West Stephen Foster Avenue, Bardstown, KY 40004 | 2012-08-26 |
| Find all providers in zip 40004 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346403326 | Erica C Greenwell | Physician Assistant | 118 Patriot Drive, Suite 102, Bardstown, KY 40004 | 2008-07-09 |
| 1265643878 | Timothy M West | Physician Assistant | 875 Pennsylvania Ave, Bardstown, KY 40004-2529 | 2007-05-25 |
| 1790735306 | Nancy Mae Hale | Physician Assistant | 118 Patriot Dr, Suite 102, Bardstown, KY 40004-9093 | 2006-05-12 |
| 1720036429 | Annandlee, Pllc | Physician Assistant | 118 Patriot Drive, Suite 102, Bardstown, KY 40004 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225591 | Alexis Garrett | Physician Assistant | 16993 Green Crest Ln, Louisville, KY 40245-3217 | 2020-11-03 |
| 1215535257 | Melissa Lee Amos | Physician Assistant | 3543 Providence Trace Dr, Melbourne, KY 41059-9203 | 2020-10-12 |
| 1780282095 | Alison Deanne Power | Physician Assistant | 3209 Keithshire Way, Lexington, KY 40503-3481 | 2020-10-09 |
| 1225635691 | Mark Douglas Crawford II | Physician Assistant | 1288 Wyan Rd, London, KY 40744-9052 | 2020-10-07 |
| 1114524188 | Dustin Scott Ammerman | Physician Assistant | 682 Reed Rd, London, KY 40741-8662 | 2020-10-02 |
| 1588270110 | Reid Van Bussum | Physician Assistant | 913 Fiddler Creek Way, Lexington, KY 40515-6460 | 2020-09-18 |
| 1568077808 | Breanna Larae Damron | Physician Assistant | 1128 Ramey Ave, Worthington, KY 41183-9229 | 2020-09-14 |
| 1477168169 | Eleshia Stephenie Sumner | Physician Assistant | 252 Sargent Rd, Pine Knot, KY 42635 | 2020-09-10 |
| 1164033353 | Tyler Roberts | Physician Assistant | Private, Louisville, KY 40241 | 2020-08-12 |
| 1902417389 | Kassandra Nicole Neltner | Physician Assistant | 2720 Marlo Way, Lakeside Park, KY 41017-2149 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.