NPI | 1700107307 |
---|---|
Former Name | STEPHANIE R KRUPKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 210) |
Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: MN 210) |
364S00000X Clinical Nurse Specialist (Licence: MN R174062-8) | |
Enumeration Date | 2010-06-17 |
Last Update Date | 2020-12-10 |