Provider Demographics
NPI:1588853493
Name:STUKE, JAMIE L (APRN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:STUKE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 COLUMBINE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOLTON
Mailing Address - State:KS
Mailing Address - Zip Code:66436
Mailing Address - Country:US
Mailing Address - Phone:785-364-2126
Mailing Address - Fax:785-986-6604
Practice Address - Street 1:117 WEST 3RD
Practice Address - Street 2:
Practice Address - City:HOYT
Practice Address - State:KS
Practice Address - Zip Code:66440
Practice Address - Country:US
Practice Address - Phone:785-986-6630
Practice Address - Fax:785-986-6604
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily