Individual
MR. TRACY DOSS NUNNALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
100 S CHERRY AVE UNIT 1, EATON, CO 80615-8256
(970) 454-3838
Mailing address
6600 W 20TH ST UNIT 26, GREELEY, CO 80634-9685
(970) 330-2039
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
185357
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0992881
CO
Other
Enumeration date
01/12/2011
Last updated
03/17/2018
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