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1356625917
TRACIE D GRACE
FARMINGTON, NM
NPI
1356625917
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NM 0064574)
Enumeration Date
2011-09-30
Last Update Date
2011-09-30
Business Address
-- TRACIE D GRACE FNP-C
407 S SCHWARTZ AVE SUITE 201
FARMINGTON, NM 87401-5925
Phone number: 505-609-6730
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Mailing Address
-- TRACIE D GRACE FNP-C
PO BOX 6210
FARMINGTON, NM 87499-6210
Phone number: 505-609-2258
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