Individual ProviderValerie L StuckyNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10021 Dupont Circle Ct, Fort Wayne, IN 46825-1604(260) 426-8117PECOS EnrollmentBased on the most recent information from CMS, provider Valerie L Stucky does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1750373601Provider TypeIndividualFull NameStucky, Valerie LCredentialNPGenderFemaleSole ProprietorNoEnumeration Date8/17/2005Last Updated2/28/2008Contact InformationPractice LocationPractice Address10021 Dupont Circle Ct, Fort Wayne, IN 46825-1604Phone(260) 426-8117Fax(260) 420-0817Mailing LocationMailing Address10021 Dupont Circle Ct, Fort Wayne, IN 46825-1604Phone(260) 426-8117Fax(260) 420-0817Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71000459AIndianaProvider IdentifiersIDDescriptionIssuerID2474620DescriptionMedicaidIssuerUnlistedOhio