NPI | 1164759585 |
---|---|
Former Name | STEPHANIE NORMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R174817) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN225137) |
363LF0000X Nurse Practitioner, Family (Licence: DC RN1038350) | |
163WL0100X Registered Nurse, Lactation Consultant (Licence: MD R174817) | |
Enumeration Date | 2009-11-05 |
Last Update Date | 2017-05-08 |