Individual
TRACEY LYNN GUSTITUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
420 S 5TH AVE, WEST READING, PA 19611-2143
(484) 628-5455
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-0799
Taxonomy
Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
SP017797
PA
Other
Enumeration date
11/09/2017
Last updated
06/12/2019
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