NPI | 1174829386 |
---|---|
Former Name | STACY HARRISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA rn170998) |
Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC R109902) |
367500000X Nurse Anesthetist, Certified Registered (Licence: MD R179251) | |
Enumeration Date | 2011-02-04 |
Last Update Date | 2015-07-14 |