Individual
TRACY LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
259 BILL FRANCE BLVD, DAYTONA BEACH, FL 32114-1316
(386) 868-1992
Mailing address
259 BILL FRANCE BLVD, DAYTONA BEACH, FL 32114-1316
(386) 868-1992
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
9483061
FL
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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