=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720975170
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDSAY JO STICE HUFF APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2025
-----------------------------------------------------
Last Update Date | 06/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 612 W STOCKTON ST
-----------------------------------------------------
City | EDMONTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42129-9458
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-432-4320
-----------------------------------------------------
Fax | 270-432-3662
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1080
-----------------------------------------------------
City | BURKESVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42717-1080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-858-6655
-----------------------------------------------------
Fax | 270-858-4027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 4042780
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------