Healthcare Provider Details

I. General information

NPI: 1679404727
Provider Name (Legal Business Name): ALLYSON JUDITH STUCKEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 SUNSET AVE STE 250
INDIANAPOLIS IN
46208-3487
US

IV. Provider business mailing address

3351 COUNTY ROAD 36
AUBURN IN
46706-9442
US

V. Phone/Fax

Practice location:
  • Phone: 317-940-6026
  • Fax:
Mailing address:
  • Phone: 260-908-2542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: