MEDICARE: AMBER L. STUCKEY APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11035888	FL
2	163WX1500X	Ostomy Care Registered Nurse	9284440	FL

General Provider Information

NPI Number	:	1346075595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER L. STUCKEY APRN

Provider Business Mailing Address
First Line	:	PO BOX 746638
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6638
Country	:	US
Telephone Number	:	904-202-2092
Fax Number	:	904-391-5001

Provider Business Practice Location Address
First Line	:	1210 VINTAGE WAY
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-0299
Country	:	US
Telephone Number	:	904-261-0922
Fax Number	:	904-390-7477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2024
Last Update Date	:	06/05/2026

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