| NPI | 1760407589 |
|---|---|
| Former Name | TRACY LYNN FAULKNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP1589) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN117748) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-03-15 |