NPI | 1720511645 |
---|---|
Former Name | SUSAN LYNN STEFANSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209015839) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209-015839) |
Enumeration Date | 2017-04-07 |
Last Update Date | 2021-07-03 |