| NPI | 1902150873 |
|---|---|
| Former Name | STEPHANIE PAIGE GOODIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-085536) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: AL 1-085536) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2016-08-29 |