STACIE RAE LARGE

FORT LEAVENWORTH, KS
NPI1407061856
Other NameSTACIE RAE KIDD
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy163W00000X Registered Nurse
(Licence: KS  14-100760-112)
Enumeration Date2007-05-11
Last Update Date2007-07-08
Business Address
Mrs. STACIE RAE LARGE RN
550 POPE AVE
FORT LEAVENWORTH, KS 66027-2332
Phone number: 913-684-6000
Mailing Address
Mrs. STACIE RAE LARGE RN
2700 S 22ND ST
LEAVENWORTH, KS 66048-4059
Phone number: 913-758-3792
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