Provider Demographics
NPI:1326186305
Name:STUMP, KAY LOUISE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:LOUISE
Last Name:STUMP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5255 OFFICE PARK BLVD
Mailing Address - Street 2:SUITE110
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-3443
Mailing Address - Country:US
Mailing Address - Phone:941-755-7000
Mailing Address - Fax:941-209-7685
Practice Address - Street 1:1862 RYE RD
Practice Address - Street 2:SUITE101
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-9038
Practice Address - Country:US
Practice Address - Phone:941-755-7000
Practice Address - Fax:941-755-7088
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1336042363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302740600Medicaid