| 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 |