| NPI | 1205477361 |
|---|---|
| Former Name | STEPHANIE SIDWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61006352) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: WA AP61006352) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2023-02-02 |