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Individual
KATHLEEN M STAGG
Active
Individual
KATHLEEN M STAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
L1-0045972
DE
363LF0000X
Family Nurse Practitioner
Primary
APRN11023429
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117033500
—
FL
Enumeration date
07/29/2015
Last updated
06/26/2024
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