| NPI | 1740811397 |
|---|---|
| Former Name | STACY R WIEMERI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9914) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 136581) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2022-09-29 |