| NPI | 1508468018 |
|---|---|
| Former Name | STEPHANIE MCGOWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 5380471092) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: KS 147897) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2021-08-27 |