| NPI | 1417188558 |
|---|---|
| Former Name | TRACY A. CAVANAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006134) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1066578) |
| 363L00000X Nurse Practitioner (Licence: KY 3006134) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9370360) | |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2018-01-10 |