| 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 |