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Individual
STACIE L STUTZMAN
Active
Individual
STACIE L STUTZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002915A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000636408
ANTHEM
IN
05
—
200971270
—
IN
Enumeration date
04/27/2009
Last updated
07/26/2011
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