| NPI | 1972185726 |
|---|---|
| Former Name | STEPHANIE NICOLE PELLING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1208900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209023155) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2025-10-03 |