NPI | 1619721289 |
---|---|
Former Name | STEPHANIE SCHRADER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP003162) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD CP003162) |
Enumeration Date | 2024-04-11 |
Last Update Date | 2024-09-12 |