| NPI | 1366577132 |
|---|---|
| Former Name | STACY LOURIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000500) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0038026) |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26nn08027300) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-05-27 |