| NPI | 1811441264 |
|---|---|
| Former Name | STACEY MARIE ROSSELOT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.019539) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH RN.356427) |
| Enumeration Date | 2016-08-14 |
| Last Update Date | 2020-02-24 |