| NPI | 1457668295 |
|---|---|
| Former Name | TRACI DAWN SHEPHERD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2013017560) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013017560) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2023-02-21 |