Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | R095739 | MD |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN1006357 | DC |
NPI | 1255458196 |
---|---|
Provider Name | Emilie Wolf Stafford |
First Address | Annapolis, MD 21409-4750 |
Second Address | Annapolis, MD 21401-3280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2007 |
Last Update Date | 08/07/2007 |