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Individual

TRACEY FULCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
12346 EASTPOINTE DR, DADE CITY, FL 33525-8651
(702) 969-5843
Mailing address
12346 EASTPOINTE DR, DADE CITY, FL 33525-8651

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9494461
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000
OPTIONAL AND NO OPTION TO SELECT N/A
Enumeration date
10/24/2019
Last updated
10/24/2019
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