| NPI | 1336133099 |
|---|---|
| Former Name | TRACY LEA RUBLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71001970A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001970A) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2008-06-16 |