NPI | 1275057325 |
---|---|
Former Name | TRACEY JUDD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH APRN.CNP.021589) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH APRN.CNP.021589) |
Enumeration Date | 2017-07-31 |
Last Update Date | 2024-12-20 |