Provider Demographics
NPI:1154087781
Name:STUCK, RACHEL L (FNP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:L
Last Name:STUCK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 VIOLET RD
Mailing Address - Street 2:
Mailing Address - City:CRITTENDEN
Mailing Address - State:KY
Mailing Address - Zip Code:41030-8956
Mailing Address - Country:US
Mailing Address - Phone:859-428-1610
Mailing Address - Fax:859-428-3923
Practice Address - Street 1:405 VIOLET RD
Practice Address - Street 2:
Practice Address - City:CRITTENDEN
Practice Address - State:KY
Practice Address - Zip Code:41030-8956
Practice Address - Country:US
Practice Address - Phone:859-428-1610
Practice Address - Fax:859-428-3923
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0030197363L00000X
KY3016985363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner