Individual
TRACY GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11990 JACKSON ST, CLINTON, LA 70722-3210
(225) 683-5292
(225) 683-1310
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-1310
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN104772
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN104772
RN LICENSE
LA
Enumeration date
01/16/2020
Last updated
01/16/2020
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