NPI | 1477816791 |
---|---|
Former Name | STORMY L SHUMWAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-100570) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 29481) |
Enumeration Date | 2012-06-21 |
Last Update Date | 2021-12-14 |