Provider Demographics
NPI:1538184593
Name:STONE, ANGELA D (APRN)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:D
Last Name:STONE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2327
Mailing Address - Country:US
Mailing Address - Phone:859-887-8400
Mailing Address - Fax:859-885-8448
Practice Address - Street 1:110 VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2327
Practice Address - Country:US
Practice Address - Phone:859-887-8400
Practice Address - Fax:859-885-8448
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1038292163W00000X
KY664P363LF0000X
KY3000664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP312OtherANTHEM BLUE CROSS/BLUE SH
KY7249033OtherAETNA HEALTHCARE PIN #
KY78003035Medicaid
KY0092790Medicare PIN
KY7249033OtherAETNA HEALTHCARE PIN #
KY0169Medicare PIN