NPI | 1689322026 |
---|---|
Former Name | STACEY L STEVENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH CNP0032773) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN355876) |
Enumeration Date | 2022-03-15 |
Last Update Date | 2022-12-07 |