Provider Demographics
NPI:1295199941
Name:KUEGEL, STACY ANN (APRN)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:ANN
Last Name:KUEGEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:N
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8211 W STATE ROUTE 66
Mailing Address - Street 2:# A
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-2534
Mailing Address - Country:US
Mailing Address - Phone:270-663-0955
Mailing Address - Fax:270-663-0957
Practice Address - Street 1:3600 FREDERICA ST STE B
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6981
Practice Address - Country:US
Practice Address - Phone:270-684-0023
Practice Address - Fax:270-684-0025
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007669A363L00000X
KY3010213363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner