NPI | 1104221415 |
---|---|
Former Name | STEPHANIE ANN WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP014364) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP014364) |
363LA2200X Nurse Practitioner, Adult Health (Licence: MD R161540) | |
Enumeration Date | 2014-10-29 |
Last Update Date | 2023-03-16 |