Provider Demographics
NPI:1295173227
Name:STUCKEY, YVONNE FLOYD
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:FLOYD
Last Name:STUCKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S BLANDING ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-2724
Mailing Address - Country:US
Mailing Address - Phone:843-374-2393
Mailing Address - Fax:
Practice Address - Street 1:125 S BLANDING ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-2724
Practice Address - Country:US
Practice Address - Phone:843-374-2393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)