STACIE L HOUSHOLDER

FORT WAYNE, IN
NPI1326394891
Former NameSTACIE L TODD
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IN  71004055A)
Enumeration Date2012-08-02
Last Update Date2022-10-20
Business Address
STACIE L HOUSHOLDER FNP-C
3909 NEW VISION DR
FORT WAYNE, IN 46845-1725
Phone number: 260-469-6602
Mailing Address
STACIE L HOUSHOLDER FNP-C
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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