NPI | 1215219373 |
---|---|
Former Name | STEPHANIE CLAIRE BANGS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95001246) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95042020) |
363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95001246) | |
Enumeration Date | 2011-09-15 |
Last Update Date | 2023-04-03 |