| NPI | 1558716324 | 
|---|---|
| Former Name | STACY LYNN BECKER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704244140) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704244140) | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704244140) | |
| Enumeration Date | 2016-04-29 | 
| Last Update Date | 2025-02-24 |