| NPI | 1649543042 |
|---|---|
| Former Name | TRACI L GOODELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: IL 209032163) |
| Additional Taxonomies | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: IL 041336983) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2025-05-01 |