| NPI | 1043583032 |
|---|---|
| Former Name | STACY ANN BREAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134115) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F343784-1) |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2021-05-18 |