| NPI | 1477825693 |
|---|---|
| Former Name | STEPHANIE K KEITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.029263) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MI 4704243963REL24001) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: NC 219035) | |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2024-03-14 |