| NPI | 1689068611 |
|---|---|
| Former Name | TRACY YAGER-JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC002632) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172423) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 00.01208013) | |
| 363LF0000X Nurse Practitioner, Family (Licence: DC RN1051472) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2019-10-23 |