Individual
STEPHANIE L MUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 MEDICAL CENTER DR, PRINCETON, KY 42445-2430
(270) 365-0300
Mailing address
100 MEDICAL CENTER DR, PRINCETON, KY 42445-2430
(270) 365-0300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1076284
KY
207RC0000X
Cardiovascular Disease Physician
Primary
3006634
KY
363L00000X
Nurse Practitioner
3006634
KY
363LF0000X
Family Nurse Practitioner
3006634
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100140490
—
KY
Enumeration date
08/12/2010
Last updated
06/19/2024
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