Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 4704296209 | MI |
NPI | 1033741533 |
---|---|
Provider Name | Stephanie Musil |
First Address | Flint, MI 48507-2677 |
Second Address | Flint, MI 48507-2677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2020 |
Last Update Date | 21/06/2021 |