NPI | 1164977286 |
---|---|
Former Name | STEPHANIE BLOCKBERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.020811) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008832) |
Enumeration Date | 2016-08-18 |
Last Update Date | 2021-08-19 |