NPI | 1194237479 |
---|---|
Former Name | STACY LUKES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5318) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 2066288) |
Enumeration Date | 2017-10-26 |
Last Update Date | 2017-10-26 |