NPI | 1184183113 |
---|---|
Former Name | STACEY SEITZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71008945A) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28191280A) |
363LF0000X Nurse Practitioner, Family (Licence: IN F03190067) | |
Enumeration Date | 2019-03-19 |
Last Update Date | 2023-10-23 |