| NPI | 1023412400 |
|---|---|
| Former Name | STEPHANIE ANDRADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 5954) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: CT 5954) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2014-11-07 |