| NPI | 1740598507 |
|---|---|
| Former Name | TRACEY LYNN WATKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: KY 3006556) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 363594) |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: CT 006114) | |
| 163W00000X Registered Nurse (Licence: CT 126171) | |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2015-07-16 |