Individual
JUDY STUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1850 LAUREL STREET, SUITE 1A, COLUMBIA, SC 29220-0001
(803) 376-5982
(803) 376-5982
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7306
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APN275
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1415
—
SC
Enumeration date
04/01/2008
Last updated
06/30/2021
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