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 |