| NPI | 1285024588 |
|---|---|
| Former Name | STACEY MARIE MOSSOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.18957) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.355077) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2024-11-01 |