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Individual
SHELLI D. TRACY
Active
Individual
SHELLI D. TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP133519
TX
363LP2300X
Primary Care Nurse Practitioner
AP133519
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1R0964
MEDICARE
TX
05
—
369856502
—
TX
Enumeration date
03/20/2017
Last updated
12/07/2021
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