NPI | 1386004877 |
---|---|
Former Name | STACEY R BRIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10000494) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5017403) |
363LF0000X Nurse Practitioner, Family (Licence: ME CNP221433) | |
363LF0000X Nurse Practitioner, Family (Licence: MO 2016003734) | |
Enumeration Date | 2016-02-26 |
Last Update Date | 2024-10-14 |