| NPI | 1376949941 |
|---|---|
| Former Name | STACEY LEIGH COON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 310143) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP014441) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2021-01-14 |