NPI | 1871342212 |
---|---|
Former Name | STEPHANIE MICHELLE O'CALLAGHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO 2024060840) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN1621307) |
Enumeration Date | 2024-05-17 |
Last Update Date | 2024-08-16 |