Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 4704302521 | MI |
NPI | 1326704867 |
---|---|
Provider Name | Giovanna Angeline Stocks |
First Address | Murfreesboro, TN 37129-2889 |
Second Address | Ann Arbor, MI 48109-4000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2021 |
Last Update Date | 09/11/2021 |