| NPI | 1174618458 |
|---|---|
| Former Name | TRACI CLEMENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110464) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 110464) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-10-05 |