Individual
ANDREA HALE STUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
4371 NEW SHEPHERDSVILLE RD, BARDSTOWN, KY 40004-8040
(502) 348-5685
(502) 331-4361
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7835
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1721
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100212110
—
KY
01
—
PA1721
MEDICAL LICENSE
KY
Enumeration date
04/30/2012
Last updated
08/12/2025
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