# DR. TRACY DANIELLE MAHVAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1689047268
- **Gender:** F
- **Credential:** PHARMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1835G0303X | Geriatric Pharmacist | 14458 | CO | — |
| 1835P0018X | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 14458 | CO | Yes |
| 1835P1200X | Pharmacotherapy Pharmacist | 14458 | CO | — |
| 1835P2201X | Ambulatory Care Pharmacist | 14458 | CO | — |

## Other

- **Enumeration date:** 11/04/2015
- **Last updated:** 11/04/2015