| NPI | 1588967038 |
|---|---|
| Former Name | TRACY S BOGARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 15411) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 15411) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2019-08-20 |