NPI | 1639432057 |
---|---|
Former Name | CYNTHIA ANN STOGSDILL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013000291) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2000148587) |
Enumeration Date | 2012-06-20 |
Last Update Date | 2019-04-29 |