Healthcare Provider Details

I. General information

NPI: 1326186305
Provider Name (Legal Business Name): KAY LOUISE STUMP ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1862 RYE RD SUITE101
BRADENTON FL
34212-9038
US

IV. Provider business mailing address

5255 OFFICE PARK BLVD SUITE110
BRADENTON FL
34203-3443
US

V. Phone/Fax

Practice location:
  • Phone: 941-755-7000
  • Fax: 941-755-7088
Mailing address:
  • Phone: 941-755-7000
  • Fax: 941-209-7685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP 1336042
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: