| NPI | 1104059492 |
|---|---|
| Former Name | STACY LYNN ROE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: AK 1095) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: OR 200950111NP NNP-PP) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2021-05-17 |