Individual
MRS. STACEY R WALDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4806 REDMON CT, LOUISVILLE, KY 40291-1449
(502) 643-5741
Mailing address
4806 REDMON CT, LOUISVILLE, KY 40291-1449
(502) 643-5741
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3013661
KY
363LF0000X
Family Nurse Practitioner
3013661
KY
363LP2300X
Primary Care Nurse Practitioner
Primary
3013661
KY
Other
Enumeration date
11/25/2019
Last updated
03/23/2026
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