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Individual

TRACI MARLOWE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ACNP

Contact information

Practice address
140 VILLAGE ST, SUITE 100, BIRMINGHAM, AL 35242-6410
(205) 980-1744
(205) 980-1334
Mailing address
140 VILLAGE ST, SUITE 100, BIRMINGHAM, AL 35242-6410
(205) 980-1744
(205) 980-1334

Taxonomy

Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
1081273
AL
363LA2100X
Acute Care Nurse Practitioner
Primary
1081273
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13792350
CAQH
AL
01
51157383
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
02/05/2015
Last updated
03/15/2016
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