| NPI | 1427740505 |
|---|---|
| Former Name | STEPHANIE KAYLAN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC APN.30457) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA NP248019) |
| Enumeration Date | 2023-05-25 |
| Last Update Date | 2025-10-13 |