NPI | 1710475363 |
---|---|
Former Name | TRACY DAWN PERKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 49417) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0993714-NP) |
Enumeration Date | 2018-04-30 |
Last Update Date | 2024-05-16 |