| NPI | 1417907189 | 
|---|---|
| Former Name | STACY L SIBLE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71002173A) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 28140959A) | 
| Enumeration Date | 2006-05-11 | 
| Last Update Date | 2023-11-20 |