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 |