NPI | 1174749121 |
---|---|
Former Name | BETTY JO STEVENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: WV 10927) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: WV 21534) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2007-07-08 |