| NPI | 1922755222 |
|---|---|
| Former Name | TRACI SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1072751) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 845457) |
| Enumeration Date | 2022-03-07 |
| Last Update Date | 2023-03-09 |