Individual
PATRICIA MARIE TRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
263 FARMINGTON AVE, GENERAL MEDICINE, FARMINGTON, CT 06030-0001
(860) 679-4477
(860) 679-1025
Mailing address
14 FOX MEADOW LN, WEST HARTFORD, CT 06107-1215
(860) 233-4009
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
004879
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124977799
—
CT
Enumeration date
12/27/2011
Last updated
02/24/2012
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