| NPI | 1932665122 |
|---|---|
| Former Name | STEPHANIE MARIE TALKEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78594-121) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019005036) |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2024-04-30 |