| NPI | 1245626092 |
|---|---|
| Former Name | KELLY ANN STUMBO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.019938) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28189752A) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2023-11-06 |