Provider Demographics
NPI:1275411449
Name:STOCKTON, AVERY JAE
Entity type:Individual
Prefix:MRS
First Name:AVERY
Middle Name:JAE
Last Name:STOCKTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47708-1621
Mailing Address - Country:US
Mailing Address - Phone:812-488-2300
Mailing Address - Fax:
Practice Address - Street 1:515 WALNUT ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47708-1621
Practice Address - Country:US
Practice Address - Phone:812-488-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program