NPI | 1962038018 |
---|---|
Former Name | TRACEE JON SCOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202202434NP-PP) |
Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: OR 201509445RN) |
Enumeration Date | 2020-03-20 |
Last Update Date | 2022-03-16 |