| NPI | 1013422682 |
|---|---|
| Former Name | STEPHANIE E SHANK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024180253) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: WV 111393) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2023-07-26 |