Provider Demographics
NPI:1609311737
Name:STUCKEY HUDSPETH, AINSLIE MIELE (NP)
Entity Type:Individual
Prefix:MRS
First Name:AINSLIE
Middle Name:MIELE
Last Name:STUCKEY HUDSPETH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:MIELE
Other - Middle Name:
Other - Last Name:HUDSPETH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1902B JACKSON AVE W
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-4206
Mailing Address - Country:US
Mailing Address - Phone:662-234-6464
Mailing Address - Fax:
Practice Address - Street 1:1902B JACKSON AVE W
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4206
Practice Address - Country:US
Practice Address - Phone:662-234-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901663363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner