| NPI | 1689980641 |
|---|---|
| Former Name | STACY LYNN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP010946) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP010946) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2023-07-10 |