Provider Demographics
NPI:1346370053
Name:STUCK, ALISON ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:ANN
Last Name:STUCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:ALISON
Other - Middle Name:ANN
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:8 RICHLAND MEDICAL PARK DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-8005
Mailing Address - Country:US
Mailing Address - Phone:803-256-6511
Mailing Address - Fax:803-744-4731
Practice Address - Street 1:8 RICHLAND MEDICAL PARK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-8005
Practice Address - Country:US
Practice Address - Phone:803-256-6511
Practice Address - Fax:803-744-4731
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3120363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3120OtherSC LICENSE
SCNP1099Medicaid
SCS980325665Medicare Oscar/Certification