NPI | 1396166989 |
---|---|
Former Name | ROXANNE STEVENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.18192-NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209011135) |
Enumeration Date | 2013-12-26 |
Last Update Date | 2024-11-08 |