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 |