Provider Demographics
NPI:1871063404
Name:STUBBLEFIELD, ALYSSA LOUISE (APRN)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LOUISE
Last Name:STUBBLEFIELD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-1658
Mailing Address - Country:US
Mailing Address - Phone:270-326-3900
Mailing Address - Fax:270-326-3905
Practice Address - Street 1:800 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1658
Practice Address - Country:US
Practice Address - Phone:270-326-3900
Practice Address - Fax:270-326-3905
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily