NPI | 1942209622 |
---|---|
Professional Name | TRACEY ANN ODISHOO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277001103) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209003621) |
363LF0000X Nurse Practitioner, Family (Licence: IL 209003621) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209003621) | |
Enumeration Date | 2005-07-15 |
Last Update Date | 2022-12-28 |