| NPI | 1609479740 |
|---|---|
| Other Name | TARA LYNN STEPHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI F03210972) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 390200000X) |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2021-04-26 |