| NPI | 1558785642 |
|---|---|
| Former Name | STEPHANIE LYNN CARR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014005153) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76261-032) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2017-09-25 |