| Doctor Name: | YVONNE SUE STUCKEY |
| NPI Number: | 1598784449 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, ANP-C |
| License Number: | 28081516A |
| Business Practice Address: | 6050 South 800 East 92 Renaissance Village Ft Wayne, IN - 46814 |
| Business Phone Number: | 2606253545 |
| Business Fax Number: | |
| Mailing Address: | 9420 Garman Rd, LEO |
| State: | IN |
| Postal Code: | 467659517 |
| Phone Number: | 2604378443 |
| Fax Number: | |
| NPI Enumeration Date: | 07/19/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 28081516A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |