| NPI | 1649725573 |
|---|---|
| Former Name | KATHY J STUMBO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010664) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 304380) |
| Enumeration Date | 2016-08-21 |
| Last Update Date | 2024-03-11 |