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Individual
GWYNN STUP
Active
Individual
GWYNN STUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.P.R,N.
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
LE-0000166
DE
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
LE-0000166
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000036563
—
DE
Enumeration date
06/11/2006
Last updated
03/05/2017
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