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Individual
TRACY SOUTHERN
Active
Individual
TRACY SOUTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2013023791
MO
363LF0000X
Family Nurse Practitioner
Primary
2017001675
MO
363LF0000X
Family Nurse Practitioner
79397
KS
Other
Enumeration date
01/17/2017
Last updated
12/08/2022
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