| NPI | 1619374451 |
|---|---|
| Former Name | STACEY CANNADY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9438343) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP141095) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2024-04-23 |