NPI | 1811614472 |
---|---|
Former Name | ELLEN MARIE STAHLMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 26641) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 240312) |
Enumeration Date | 2022-10-25 |
Last Update Date | 2025-02-06 |