| NPI | 1598496853 |
|---|---|
| Former Name | STACEY JANE LUCZAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 13077) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: WI 219802) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2022-09-20 |