| NPI | 1700425386 |
|---|---|
| Former Name | MARCUS STEPHENSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-141024) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-141024) |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2023-08-09 |