Individual
SHERYL ANN STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
610 E BRANNON RD STE 100, NICHOLASVILLE, KY 40356-6065
(859) 260-5540
Mailing address
5200 COMMERCE CROSSING 3RD FL, LOUISVILLE, KY 40229
(502) 861-5278
(502) 861-5278
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3005514
KY
363LF0000X
Family Nurse Practitioner
APN0000013260
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020248399
DEPT OF LABOR EEOICP
—
05
—
3341579
—
TN
05
—
7100041640
—
KY
Enumeration date
02/15/2008
Last updated
08/12/2024
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