| NPI | 1407416175 |
|---|---|
| Former Name | STEPHANIE MELISSA MULKA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 8324) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2324164) |
| 363L00000X Nurse Practitioner (Licence: CT 112872) | |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2021-08-16 |