| NPI | 1962123646 |
|---|---|
| Former Name | KACIE L SHAEFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.025658) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.025658) |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2023-02-09 |