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Individual
TRACI HARRIS
Active
Individual
TRACI HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
198169
WI
363LA2200X
Adult Health Nurse Practitioner
20900440
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
209004400
IL
363LF0000X
Family Nurse Practitioner
209004400
IL
Other
Enumeration date
12/17/2007
Last updated
01/30/2019
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