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Individual
TRACY GAYLE PORTER
Active
Individual
TRACY GAYLE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
169072
GA
363LF0000X
Family Nurse Practitioner
263364
NC
Other
Enumeration date
01/22/2007
Last updated
09/12/2013
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