Provider Demographics
NPI:1316109325
Name:STUCKEY, SHARON KAYE
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:KAYE
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 1:462 STAN MCDANIEL RD
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-3238
Mailing Address - Country:US
Mailing Address - Phone:478-374-1739
Mailing Address - Fax:
Practice Address - Street 1:462 STAN MCDANIEL RD
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-3238
Practice Address - Country:US
Practice Address - Phone:478-374-1739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN089938163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine