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 | 2024-11-12 |