NPI | 1215208871 |
---|---|
Former Name | TRACY L SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 111328) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A116519) |
Enumeration Date | 2012-01-13 |
Last Update Date | 2019-12-10 |