| NPI | 1871720409 |
|---|---|
| Former Name | COLLEEN KATHERINE STUCKEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 572) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2022-10-09 |