| NPI | 1124678156 |
|---|---|
| Former Name | MISTY RAE STAUFFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F09190179) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 897445) |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2022-01-16 |