NPI | 1215702618 |
---|---|
Former Name | STEPHANI D DUELGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 14728-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 221970-30) |
Enumeration Date | 2023-11-16 |
Last Update Date | 2023-11-16 |