Provider Demographics
NPI:1962229856
Name:STINER, NICOLE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:STINER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 GLENSBORO RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-9033
Mailing Address - Country:US
Mailing Address - Phone:502-839-4091
Mailing Address - Fax:502-839-9650
Practice Address - Street 1:1080 GLENSBORO RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-9033
Practice Address - Country:US
Practice Address - Phone:502-839-4091
Practice Address - Fax:502-839-9650
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4026523363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health