NPI | 1023323342 |
---|---|
Former Name | STEPHANIE SUZANNE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1049834) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN218375) |
363LF0000X Nurse Practitioner, Family (Licence: AL 1-105754) | |
Enumeration Date | 2010-08-11 |
Last Update Date | 2025-08-28 |