NPI | 1316108301 |
---|---|
Former Name | TRACEY F DURST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 201504213NP-PP) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME AP081908) |
363LF0000X Nurse Practitioner Family (Licence: ME R052968) | |
Enumeration Date | 2008-06-23 |
Last Update Date | 2023-12-11 |