NPI | 1922396803 |
---|---|
Former Name | TRACY L BRAZZIEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP120514) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 625141) |
Enumeration Date | 2011-07-13 |
Last Update Date | 2020-06-29 |