| NPI | 1952699019 |
|---|---|
| Former Name | STACI RENEA BREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: KS 53-75385-061) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2019-08-09 |