| NPI | 1164760245 |
|---|---|
| Former Name | STACY MARIE SHELTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP8669) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 22570) |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2019-07-15 |