Individual
DR. STEPHANIE ANNE NITZKEN WEEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
530 SOUTH JACKSON STREET, LOUISVILLE, KY 40201
(502) 852-5851
Mailing address
P.O. BOX 909, LOUISVILLE, KY 40201
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
TP511
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/15/2011
Last updated
07/16/2015
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