WANDA RAYE STIDHAM

HAZARD, KY
NPI1821982489
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: KY  4042301)
Enumeration Date2025-06-06
Last Update Date2026-05-08
Business Address
WANDA RAYE STIDHAM
181 ROY CAMPBELL DR
HAZARD, KY 41701-9407
Phone number: 606-439-1316
Mailing Address
WANDA RAYE STIDHAM
453 OLD KY 11
BOONEVILLE, KY 41314-9171
Phone number: 606-593-6400