| NPI | 1821626441 |
|---|---|
| Former Name | STEPHANIE DEVORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: KY 1066580) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014951) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2021-08-24 |