| NPI | 1376597393 |
|---|---|
| Former Name | TRACI POLLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024174669) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: PA SP008121) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2017-05-15 |