Provider Demographics
NPI:1376015602
Name:SPALDING, STEFANIE KAYE (MSN, APRN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:KAYE
Last Name:SPALDING
Suffix:
Gender:F
Credentials:MSN, APRN, NP-C
Other - Prefix:
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Mailing Address - Street 1:320 N LORETTO RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-1300
Mailing Address - Country:US
Mailing Address - Phone:270-692-5187
Mailing Address - Fax:270-699-4621
Practice Address - Street 1:320 N LORETTO RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-1300
Practice Address - Country:US
Practice Address - Phone:270-692-5187
Practice Address - Fax:270-699-4621
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3012969207Q00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine