| NPI | 1265740872 |
|---|---|
| Former Name | STACEY L. KINGERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.11723) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.11723) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2025-01-24 |