| 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 Psychiatric/Mental Health (Licence: IL 209003621) | |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2022-12-28 |