| NPI | 1093148512 |
|---|---|
| Former Name | STEPHANIE K MORTENSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5373) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5373) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2025-02-27 |