| NPI | 1033681655 |
|---|---|
| Former Name | TRACEY SOPER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020358) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5020358) |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2025-12-23 |