| NPI | 1386048023 |
|---|---|
| Former Name | SHANNON L STOVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2014036832) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2006019382) |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2021-03-22 |