Individual
JANICE M STUCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 293-8228
(937) 293-8229
Mailing address
3533 SOUTHERN BLVD STE 3400, KETTERING, OH 45429-1288
(937) 293-8228
(937) 293-8229
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN-153426
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0793342
—
OH
Enumeration date
03/17/2006
Last updated
05/29/2019
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