| NPI | 1336788850 |
|---|---|
| Former Name | TRACY KAY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NM 58842) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R64921) |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2023-06-14 |