NPI | 1750861969 |
---|---|
Former Name | STACEY ALLYSUN LANSDOWNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8624) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 197066) |
363LF0000X Nurse Practitioner, Family (Licence: WI 8624) | |
Enumeration Date | 2018-08-16 |
Last Update Date | 2021-11-24 |