| NPI | 1629341201 |
|---|---|
| Former Name | STEPHANIE BETH PHILLIPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0997922-NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A113521) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2022-10-05 |