| NPI | 1790115293 |
|---|---|
| Former Name | STACEY MARIE MEYERS-PROSYNIUK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209021975) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN210777) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.021975) | |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2022-10-07 |