| NPI | 1649721721 |
|---|---|
| Former Name | STACEY TEEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 78089) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 78089) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2022-07-21 |