| NPI | 1528311453 |
|---|---|
| Former Name | STEPHANIE MICHELLE WATSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN.124282-M-IV) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2012-10-16 |