| NPI | 1497391924 |
|---|---|
| Former Name | STEPHNIE MICHELLE WRIEDT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019043385) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2019043385) |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2023-07-21 |