| NPI | 1578276051 |
|---|---|
| Former Name | TRACY SHELLHORN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209026644) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209026644) |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2026-06-29 |