| NPI | 1649542143 |
|---|---|
| Former Name | STEPHANIE LYNN THOMAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA 190528) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN190528) |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2020-01-28 |