NPI | 1669983839 |
---|---|
Former Name | STEFANIE JOY WETZEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7958) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA F05170771) |
363LF0000X Nurse Practitioner, Family (Licence: MN CNP7958) | |
Enumeration Date | 2017-10-16 |
Last Update Date | 2025-07-03 |