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Individual
STEPHANIE CAUDILL
Active
Individual
STEPHANIE CAUDILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
3013678
KY
363L00000X
Nurse Practitioner
3013678
KY
363LF0000X
Family Nurse Practitioner
Primary
3013678
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100703400
—
KY
Enumeration date
09/12/2020
Last updated
11/16/2020
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