Individual
ALICIA D STIDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
245 FLEMINGSBURG RD, MOREHEAD, KY 40351-1015
(606) 780-5500
(606) 783-7281
Mailing address
41 HOMEPLACE WAY, MOREHEAD, KY 40351-9071
(606) 784-5894
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3015232
KY
363LF0000X
Family Nurse Practitioner
Primary
3015232
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3015232
KY MEDICAL LICENSE
KY
Enumeration date
10/02/2020
Last updated
03/18/2021
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