# TRACEE TABARES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1033732995
- **Gender:** F
- **Credential:** FNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0200X | Pediatric Registered Nurse | 0001271471 | VA | — |
| 363L00000X | Nurse Practitioner | 0024180389 | VA | — |
| 363L00000X | Nurse Practitioner | AC003567 | MD | Yes |

## Other

- **Enumeration date:** 05/26/2020
- **Last updated:** 06/21/2021