| NPI | 1134225923 |
|---|---|
| Former Name | JILL D STAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005482) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 5482P) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2016-06-29 |