Individual
LEAH MARIE STUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A-GNP-C
Contact information
Practice address
229 W STEWART AVE, MEDFORD, OR 97501-3663
(541) 779-5531
Mailing address
1092 US HIGHWAY 224, NOVA, OH 44859-9770
(330) 416-1605
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AG06220193
OH
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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