Individual
MS. TRACY LYNN MONTICONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7011 A C SKINNER PKWY, JACKSONVILLE, FL 32256-6954
(904) 612-4848
Mailing address
13442 TEDDINGTON LN, JACKSONVILLE, FL 32226-5873
(904) 612-4848
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
9429731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1
—
FL
Enumeration date
12/06/2019
Last updated
12/06/2019
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