| NPI | 1275077398 | 
|---|---|
| Former Name | HEATHER DANIELLE STANFORD | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-121972) | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: AL 1-121972) | 
| Enumeration Date | 2016-12-08 | 
| Last Update Date | 2022-08-10 |