| NPI | 1831664242 |
|---|---|
| Former Name | STEPHANIE JO SHAWVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-ARPN-LIC-132152) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2019-04-02 |