| NPI | 1982951612 |
|---|---|
| Former Name | TRACY CAROLYN SIMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 7123) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP60307006) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2017-08-21 |