| NPI | 1043764467 |
|---|---|
| Former Name | STEPHANIE LYNN MCCRACKEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP8835) |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-12-13 |