| NPI | 1548496508 |
|---|---|
| Former Name | STACEY LOUISE MULLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.10652) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.10652-NP) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2024-07-10 |