| NPI | 1093076531 |
|---|---|
| Former Name | STEPHANIE ANNE BLACKBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007414) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3007414) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2024-02-02 |