| NPI | 1235155722 |
|---|---|
| Former Name | STACI C PERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71002004A) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 71002004A) |
| 363LF0000X Nurse Practitioner Family (Licence: IN 71002004A) | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: IN 71002004A) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2020-06-11 |