| NPI | 1659725430 |
|---|---|
| Former Name | TRACY MICHELLE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71006674A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28184763A) |
| 363L00000X Nurse Practitioner (Licence: IN 71006663A) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2023-02-16 |