| NPI | 1215726377 |
|---|---|
| Former Name | HEATHER STAEBEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2392000) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2392000) |
| 163W00000X Registered Nurse (Licence: ME RN76935) | |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-08-25 |