| NPI | 1508533712 |
|---|---|
| Former Name | STACIE NICOLE HARRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3016583) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: KY 3016583) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3016583) | |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2023-02-02 |