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Active NPI 1821982489 Individual Practitioner Female Practitioner

Wanda Raye Stidham

Nurse Practitioner - Primary Care • Hazard, KY

Professional Overview & Biography Verified Profile Summary

Wanda Stidham is a certified Nurse Practitioner - Primary Care practicing in Hazard, KY. With approximately 2 years of clinical experience since completing medical education in 2024, Wanda Stidham delivers high-quality medical care to the local community at 181 ROY CAMPBELL DR.

Wanda Stidham does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

181 Roy Campbell Dr

Hazard, KY 417019407

Telephone 6064391316
Associated Practice Facility / Clinic
🏢 Ace Clinique Of Medicine Facility NPI 1306862057

Medicare Profile & Education

Medical School

Other

Graduation Year

2024

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Primary Care in Hazard, KY

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
2 Yrs Matches City Avg
City Avg: 2.0 Yrs
State Avg: 8.3 Yrs
Regional Practice Density
1 Specialists

Practicing in Hazard, KY (117 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Stidham (2 Years) 2 Yrs
Hazard Specialty Average (2.0 Years) 2.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2026-05-08
Nurse Practitioner - Primary Care Primary Specialty

NUCC Taxonomy Code: 363LP2300X

State License KY 4042301

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Mary Engle , PA-C

Physician Assistant

NPI 1023025384

Physician Assistant (Certified)

Suzanne Price , APRN

Nurse Practitioner

NPI 1245295138

Advanced Practice Registered Nurse

Dr. James Hammock , MD

Physical Medicine & Rehabilitation

NPI 1245470426

Doctor of Medicine (M.D.)

Whitni Boggs , FNP-C

Nurse Practitioner - Family

NPI 1407730690

Family Nurse Practitioner (Certified)

NPI 1467455519

Doctor of Medicine (M.D.)

Dr. Christopher Yost , MD

Internal Medicine

NPI 1467744086

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location May 08, 2026

Registered at 181 ROY CAMPBELL DR, HAZARD, KY 417019407 (Tel: 6064391316)

NPI Profile Active June 06, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location June 06, 2025

Registered at 453 OLD KY 11, BOONEVILLE, KY 413149171 (Tel: 6065936400)

📍
Updated Business Mailing Address June 06, 2025

Registered at 453 OLD KY 11, BOONEVILLE, KY 413149171 (Tel: 6065936400)

👤
Provider Name / Credentials Updated June 06, 2025

Recorded as WANDA STIDHAM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 06, 2025

Nurse Practitioner (License #4042301 in KY)

🟢
Initial NPI Registration & Enumeration June 06, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1821982489
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 06, 2025
Last Update: May 08, 2026
Sole Proprietor: No

Mailing Address

453 Old Ky 11

Booneville, KY 413149171

Phone: 6065936400

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.