Individual
TRACY TABACCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
697 PRO-MED LN, CARMEL, IN 46032-5323
(317) 587-0500
(317) 574-1234
Mailing address
697 PRO-MED LN, CARMEL, IN 46032-5323
(317) 587-0567
(317) 574-1230
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
28164209A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073590
—
IN
Enumeration date
05/29/2009
Last updated
05/29/2009
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