| NPI | 1720338569 |
|---|---|
| Other Name | TRACIE BRACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN2527812) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2527812) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2024-06-20 |