NPI | 1437405438 |
---|---|
Former Name | STACEY ANN SIMMONS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.13496) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.13496-NP) |
Enumeration Date | 2012-07-27 |
Last Update Date | 2019-11-08 |