Individual
TRACY B. ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
(318) 629-4833
Mailing address
1512 W KIRBY PL, SHREVEPORT, LA 71103-3822
(318) 626-0177
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
232136
LA
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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