| NPI | 1518236785 |
|---|---|
| Former Name | STEPHANIE CANDICE JOHNSON MOONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: ID 1341A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OR -201150178NP) |
| Enumeration Date | 2011-12-17 |
| Last Update Date | 2021-07-16 |