NPI | 1811278989 |
---|---|
Former Name | TRACEY LEE DEARING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1333) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN R147500-3) |
363L00000X Nurse Practitioner (Licence: WI 102863) | |
363LF0000X Nurse Practitioner Family (Licence: WI 102863) | |
Enumeration Date | 2011-09-02 |
Last Update Date | 2025-06-23 |