Individual
TRACIE M NAILLIEUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3575 MOREAU CT STE 200, SOUTH BEND, IN 46628-4387
(219) 248-3666
(219) 764-8403
Mailing address
3575 MOREAU CT STE 200, SOUTH BEND, IN 46628-4387
(219) 248-3666
(219) 764-8403
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28287900A
IN
Other
Enumeration date
12/04/2025
Last updated
01/08/2026
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