| NPI | 1467916148 |
|---|---|
| Former Name | STACY MARIE REEVES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MD R201835) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R201835) |
| Enumeration Date | 2019-01-26 |
| Last Update Date | 2019-01-26 |