NPI | 1659810935 |
---|---|
Former Name | STEPHANIE GALE DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: GA RN160287) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN160287) |
Enumeration Date | 2017-02-19 |
Last Update Date | 2020-06-15 |