| Doctor Name: | STACEY M ANDERSON |
| NPI Number: | 1013300896 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 3009247 |
| Business Practice Address: | 148 Skyview Dr Mt Sterling, KY - 403531496 |
| Business Phone Number: | 8594990717 |
| Business Fax Number: | 8594990926 |
| Mailing Address: | 148 Skyview Dr, MT STERLING |
| State: | KY |
| Postal Code: | 403531496 |
| Phone Number: | 8594990717 |
| Fax Number: | |
| NPI Enumeration Date: | 03/18/2015 |
| NPI Last Update Date: | 12/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 3009247 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |