| NPI | 1336852094 |
|---|---|
| Former Name | TRACI ANN PITTEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10956-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 350854) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95017747) | |
| Enumeration Date | 2022-12-27 |
| Last Update Date | 2022-12-27 |