NPI | 1528364460 |
---|---|
Former Name | STACY FORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: UT 5188629-4406) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 5188629-4405) |
Enumeration Date | 2011-02-09 |
Last Update Date | 2024-02-22 |