NPI | 1861853301 |
---|---|
Former Name | STACIA L. WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: IN 71006146A) |
Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: IN 71006146) |
363LN0000X Nurse Practitioner, Neonatal (Licence: IN 28171919) | |
Enumeration Date | 2016-03-11 |
Last Update Date | 2023-10-02 |