| NPI | 1528323839 |
|---|---|
| Former Name | TRACY LYNN STEVENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN314960) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F337399) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2023-02-13 |