Individual
TRACY KATHRYN GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-1030
Mailing address
777 HEMLOCK ST, MACON, GA 31201-2102
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN254639
GA
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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