| NPI | 1619200128 |
|---|---|
| Former Name | STACEY L. SHAYDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003132) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12869) |
| 363A00000X Physician Assistant (Licence: MA PA100237) | |
| 363A00000X Physician Assistant (Licence: AZ 9042) | |
| 363A00000X Physician Assistant (Licence: TX PA17043) | |
| 363A00000X Physician Assistant (Licence: NY 028296) | |
| 363A00000X Physician Assistant (Licence: WA PA61433652) | |
| 363A00000X Physician Assistant (Licence: MD C08341) | |
| 363A00000X Physician Assistant (Licence: GA 11549) | |
| 363A00000X Physician Assistant (Licence: CO PA.0007864) | |
| 363A00000X Physician Assistant (Licence: CA 53299) | |
| 363A00000X Physician Assistant (Licence: SC 4698) | |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2024-10-18 |