NPI | 1154501807 |
---|---|
Former Name | TRACEY DAWN MACKLING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP116428) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP116428) |
Enumeration Date | 2007-11-10 |
Last Update Date | 2025-07-14 |