NPI | 1659651016 |
---|---|
Former Name | STACEY POWELL-SMITH; POWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0990161-NP) |
Enumeration Date | 2011-08-17 |
Last Update Date | 2022-08-23 |