NPI | 1154693539 |
---|---|
Former Name | STEPHANIE SUSAN ORTH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60642414) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60642414) |
Enumeration Date | 2012-02-01 |
Last Update Date | 2019-03-04 |