| NPI | 1114102332 |
|---|---|
| Former Name | STACEY M CORDWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 212620) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: MA 212620) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2008-02-10 |