| NPI | 1114176641 |
|---|---|
| Former Name | TRACY K ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 3495-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 3495-33) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2025-03-04 |