Individual
TRACY JO WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 N MAIN ST, ROANOKE, IL 61561-7585
(309) 923-2661
(309) 923-7628
Mailing address
900 W MAPLE ST, CANTON, IL 61520-2953
(309) 678-1368
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
209024834
IL
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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