| NPI | 1831956291 |
|---|---|
| Former Name | STEPHANIE LEA WILLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: VA 0024191363) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: VA 0001238197) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024191363) | |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-10-25 |