Provider Demographics
NPI:1033686555
Name:STORY, CARLA SUE (APRN)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:SUE
Last Name:STORY
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 1:2003 OLD MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056
Mailing Address - Country:US
Mailing Address - Phone:606-759-7878
Mailing Address - Fax:606-313-5390
Practice Address - Street 1:2003 OLD MAIN STREET
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056
Practice Address - Country:US
Practice Address - Phone:606-759-7878
Practice Address - Fax:606-313-5390
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012840363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily