NPI | 1568098333 |
---|---|
Former Name | STACY ANN MORTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11013535) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9351388) |
Enumeration Date | 2020-03-12 |
Last Update Date | 2021-10-15 |