| NPI | 1790977973 |
|---|---|
| Former Name | TRACY LYNN MELANCON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP03216) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: LA RN078784-AP03216) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: LA RN078784-AP03216) | |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2013-06-11 |