Individual
STEPHANIE BETH TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1653
(270) 825-5100
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1096558
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1096558
LICENSE
KY
05
—
7100020780
—
KY
Enumeration date
11/01/2007
Last updated
09/22/2018
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